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  Citation statistics : Table of Contents
   2005| April-June  | Volume 23 | Issue 2  
 
 
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BRIEF COMMUNICATION
Evaluation of Methods for AmpC Beta-Lactamase in Gram Negative Clinical Isolates from Tertiary Care Hospitals
S Singhal, T Mathur, S Khan, DJ Upadhyay, S Chugh, R Gaind, A Rattan
April-June 2005, 23(2):120-124
DOI:10.4103/0255-0857.16053  PMID:15928443
The purpose of this study was to simultaneously screen for Extended-spectrum b-lactamases (ESBL) and AmpC b-lactamases in gram negative clinical isolates from four tertiary care hospitals and further to compare two detection methods three-dimensional extraction method and AmpC disk test for AmpC b-lactamases. A total of 272 isolates were screened for ESBL and AmpC β-lactamase by modified double disk approximation method (MDDM). Synergy observed between disks of ceftazidime/cefotaxime and clavulanate were considered as ESBL producer. Isolates showing reduced susceptibility to either of the test drugs (ceftazidime or cefotaxime) and cefoxitin were considered as presumptive AmpC producers and further confirmed by three-dimensional extraction method and AmpC disk test. A total of 173 (64%) of the isolates were found to be ESBL positive and 61 (23%) showed resistant to cefoxitin. ESBL was detected in 80 (62%) isolates of E. coli and 71 (73%) of Klebsiella spp. The occurrence of AmpC b-lactamases was found to be 8% (22) of the total isolates and the two detection methods for AmpC b -lactamase showed concordant results. Screening for ESBL and AmpC can be simultaneously done by MDDM method and confirmation for AmpC β-lactamase should be carried out routinely in tertiary care hospitals by AmpC disk test, as it is a simple and rapid procedure.
  77 20,598 1,732
REVIEW ARTICLE
Association of Parasitic Infections and Cancers
S Khurana, ML Dubey, N Malla
April-June 2005, 23(2):74-79
DOI:10.4103/0255-0857.16044  PMID:15928434
Recent advances in the fields of molecular biology, epidemiology and infectious diseases have led to significant revelations to clarify the relationship between cancer and infective agents. This article reviews the relationship between parasitic infections and carcinogenesis and the possible mechanisms involved. Few parasites, e.g., Schistosoma haematobium and Opisthorchis viverrini have been found to be strongly associated with bladder cancer and cholangiocarcinoma respectively. The evidence for the association of several other parasites and cancers has also been postulated.
  42 31,186 1,257
BRIEF COMMUNICATION
A Study on the Perinatal Transmission of the Hepatitis B Virus
A Chakravarti, D Rawat, M Jain
April-June 2005, 23(2):128-130
DOI:10.4103/0255-0857.16055  PMID:15928445
The purpose of this study was to determine the age wise prevalence of Hepatitis B virus (HBV) in children under five years and to analyze the relative importance of horizontal or vertical transmission. This study included 400 children in the age group of less than five years attending the outpatient department of pediatrics with minor complaints. History of HBV immunization was taken as the exclusion criteria. All the samples were tested for Hepatitis B surface antigen (HBsAg) and anti HBs using commercial ELISA kits. Liver function tests were performed on all the HBsAg positive patients. Hepatits B nucleocapsid antigen (HBeAg) was detected in few HBsAg positive mothers. Overall HBsAg positivity in children below five years was 2.25%. There was no statistically significant difference in HBsAg positivity in the different age groups by chi square test. HBsAg positivity in mothers was 4.25%. However only in three cases the pair of mother and child were both positive for HBsAg. The mean anti HBs positivity in children was 23.75%. There was no statistically significant difference in the anti HBs positivity in different age groups of children. The observation that there is no statistically significant difference in the prevalence of HBV infection (HBsAg and HBs) amongst different age groups of children below five years signifies that a large proportion of HBV infection in children of this age is acquired via vertical transmission. It is also indicated that this mode of disease transmission is responsible for the majority of chronic carriers. Universal immunization of all infants is desirable to decrease the carrier pool and it is inferred from the present study that Hepatitis B immunization should begin at birth to have greater impact.
  28 9,635 474
REVIEW ARTICLE
Microsporidia: Emerging Ocular Pathogens
J Joseph, GK Vemuganti, S Sharma
April-June 2005, 23(2):80-91
DOI:10.4103/0255-0857.16045  PMID:15928435
Microsporidia are eukaryotic, spore forming obligate intracellular parasites, first recognized over 100 years ago. Microsporidia are becoming increasingly recognized as infectious pathogens causing intestinal, ocular, sinus, pulmonary, muscular and renal diseases, in both immunocompetent and immunosuppressed patients. Ocular microsporidiosis, though uncommon, could be isolated or part of systemic infections. It occurs mainly in two forms: keratoconjunctivitis form, mostly seen in immunocompromised individuals; stromal keratitis form seen in immunocomptetant individuals. Recent reports indicate increasing number of cases of ocular microsporidiosis in immunocompetent individuals. The ocular cases present as superficial keratitis in AIDS patients, and these differ in presentation and clinical course from the cases seen in immunocompetent individuals which mainly appear to be as deep stromal keratitis. For most patients with infectious diseases, microbiological isolation and identification techniques offer the most rapid and specific determination of the etiologic agent, however this does not hold true for microsporidia, which are obligate intracellular parasites requiring cell culture systems for growth. Therefore, the diagnosis of microsporidiosis currently depends on morphological demonstration of the organisms themselves, either in scrapings or tissues. Although the diagnosis of microsporidiosis and identification of microsporidia by light microscopy have greatly improved during the last few years, species differentiation by these techniques is usually impossible and electron microscopy may be necessary. Immuno fluorescent-staining techniques have been developed for species differentiation of microsporidia, but the antibodies used in these procedures are available only at research laboratories at present. During the last 10 years, molecular techniques have been developed for the detection and species differentiation of microsporidia.
  24 24,095 813
CASE STUDY
Epidemiological, Clinical and Prognostic Profile of Acute Bacterial Meningitis among Children in Alexandria, Egypt
HF M Farag, MM Abdel-Fattah, AM Youssri
April-June 2005, 23(2):95-101
DOI:10.4103/0255-0857.16047  PMID:15928437
Purpose: To address the epidemiological characteristics and clinical indices that may predict the prognostic profile of meningitis among children. Methods: Children admitted to Alexandria fever hospital with clinical diagnosis of meningitis/meningoencephalitis during the period 2002-2003 were recruited for the study. They were subjected to clinical examination as well as CSF bacteriological and serological investigations Results: Three hundred and ten patients (195 males and 115 females) were included. About 65.2% of them were infected with acute bacterial meningitis (ABM) and 34.8% were infected with aseptic meningitis. In this study, ABM was caused by Haemophilus influenzae (21%), Streptococcus pneumoniae (13.9%), Neisseria meningitidis (14.2%) and other undetermined bacteria (16.1%). ABM showed significant association with age group 1-9 years (66.3%), low socio-economic class (96%), working mother (83.2%), more than two smokers in the family (62.9%) and cold seasons(fall 35.1% and winter 48.5%). Aseptic meningitis showed significant association with age group 3-15 months (100%) and previous immunization(81.5%). The overall case fatality rate was 10.3%; 13.9% for ABM and 3.4% for aseptic meningitis. 7.1% of all survivors developed epileptic attacks. Predictors for death or epilepsy events were high WHO meningitis score (> 9), decreased CSF glucose level (<10 mg/dL), more smokers in the family, generalised seizures, infancy (<1year of age) and working mothers. Conclusion: This study highlights the importance of several predictors of the outcome of meningitis in children. It is concluded that quick and simple scoring scales, such as the WHO scale, are not only applicable but valuable prognostic tools for meningitis in children.
  22 17,310 685
BRIEF COMMUNICATION
Study of Clinical Profile and Antibiotic Response in Typhoid Fever
MN Chowta, NK Chowta
April-June 2005, 23(2):125-127
DOI:10.4103/0255-0857.16054  PMID:15928444
The objective of the present study is to evaluate the clinical profile and pattern of various drugs used in the treatment of typhoid fever. A retrospective analysis of adult patients suffering from typhoid fever was done at Kasturba Medical College hospital, Attavar during the year 1999-2001. Diagnosis of patients was based on clinical features, widal test and blood culture. The sensitivity pattern of isolates from blood culture was recorded. The mode of presentation, clinical course, treatment history, laboratory investigations reports, antibiotic administered, response to therapy and the complications were recorded. Total number of 44 cases of typhoid fever were studied. Out of these 21(47.7%) were males and 23(52.3%) were females. Average age of presentation was 23.9 years. Average duration of hospital stay was 10.8 days. Fever was present in all patients. Resistance of S. typhi to amoxicillin, chloramphenicol, ampicillin and co-trimoxazole were significantly high. Ciprofloxacin also showed resistance in 18.1% of cases. Sensitivity to cephalosporin was 100% in our study. Ciprofloxacin was the most commonly used antibiotic in our study (23 patients). Chloramphenicol alone was used in 2 patients and in 3 patients it was given after 6 days of ciprofloxacin treatment. Third generation cephalosporins(ceftriaxone) alone were used in 16 patients. Indiscriminate use of drugs in typhoid fever should be discouraged. Appropriate antibiotic as indicated by sensitivity tests should be employed to prevent the development of resistant strains of S. typhi.
  20 15,264 858
Multiplex PCR on Leptospiral Isolates from Kolenchery, Kerala, India
S Sugathan, TP Varghese
April-June 2005, 23(2):114-116
DOI:10.4103/0255-0857.16051  PMID:15928441
Human leptospirosis causes severe multiorgan dysfunctions that may end in multiorgan failure and death. The methods in hand for diagnosis of leptospirosis like culture, ELISA and MAT only help to confirm the disease, and are of little value in early detection. The aim of this study was to find out if the two sets of primers described earlier could detect all the isolates from the area, for the purpose of using the resultant database for early detection of leptospires in future from clinical specimens. The study was done on culture isolates from Jan 2000 to June 2002 attending the department of medicine, MOSC medical college hospital, Kolenchery, Kerala, India. DNA of 45 culture isolates were amplified by multiplex PCR using two sets of previously described primers, G1, G2 and B 64-I, B 64-II. Specific amplifications of either 285 or 563 bp size were obtained from all isolates included in the study indicating the utility of the multiplex PCR in the rapid detection of leptospires in clinical samples.
  19 8,398 341
CASE STUDY
Pleuropulmonary Paragonimiasis mimicking Pulmonary Tuberculosis - A Report of Three Cases
TN Singh, S Kananbala, KD Devi
April-June 2005, 23(2):131-134
DOI:10.4103/0255-0857.16056  PMID:15928446
Paragonimiasis is an important cause of pulmonary disease worldwide. Infection in humans mainly occurs by ingestion of raw or undercooked freshwater crabs or crayfishes. The disease is well known in endemic regions of Asian countries, where culturally based methods of food preparation foster human transmission. Three patients with clinical and radiological features compatible with pulmonary tuberculosis had been treated for tuberculosis without remedy despite an inability to demonstrate acid fast bacilli in sputum smears. All patients had history of ingestion of raw crabs and crayfishes. The confirmed diagnosis of pleuropulmonary paragonimiasis was made based on the demonstration of Paragonimus eggs in the sputum, and high absolute eosinophilia in their peripheral blood and pleural fluid. All the patients had been treated with praziquantel successfully.
  16 14,524 311
SPECIAL ARTICLE
Multidrug Resistant Salmonella typhi in Asymptomatic Typhoid Carriers among Food Handlers in Namakkal District, Tamil Nadu
B Senthilkumar, G Prabakaran
April-June 2005, 23(2):92-94
DOI:10.4103/0255-0857.16046  PMID:15928436
Purpose: to screen Salmonella typhi in asymptomatic typhoid carriers and to find out drug resistance and ability of the strains to transmit drug resistance to other bacteria. Methods: Cultural characters, biochemical tests, antibiotic sensitivity test (disc diffusion), agarose gel electrophoresis, and conjugation protocols were done. Thirty five stool samples were collected from the suspected food handlers for the study. Results: Among 35 samples, (17.14%) yielded a positive result. Out of these 4 (20.0%) were women and 2 (13.33%) were men. The isolates were tested with a number of conventional antibiotics viz, amikacin, amoxicillin, ampicillin, chloramphenicol, ciprofloxacin, co-trimaxazole, rifampicin, gentamicin, nalidixic acid, ofloxacin and tetracycline. Five isolates were having the multidrug resistant character. Four (66.66%) multidrug resistant isolates were found to have plasmids, while one (16.66%) multidrug resistant isolate had no plasmid and the chromosome encoded the resistance. Only one strain (16.66%) showed single antibiotic resistance in the study and had no plasmid DNA. The molecular weights of the plasmids were determined and found to be 120 kb.The mechanism of spreading of drug resistance through conjugation process was analyzed. In the conjugation studies, the isolates having R+ factor showed the transfer of drug resistance through conjugation, which was determined by the development of antibiotic resistance in the recipients. Conclusion: This study shows that drug resistant strains are able to transfer genes encoding drug resistance.
  14 13,673 549
ORIGINAL ARTICLE
Prevalence of HCV Infection in Patients on Haemodialysis: Survey by Antibody and Core Antigen Detection
AK Reddy, KV D Murthy, V Lakshmi
April-June 2005, 23(2):106-110
DOI:10.4103/0255-0857.16049  PMID:15928439
Purpose: The present study was undertaken to determine the prevalence of HCV infection by antibody testing and HCV core antigen (HCVcAg) determination by ELISA in haemodialysis patients and to evaluate the HCV c Ag assay in the detection of HCV infected patients on haemodialysis. Materials and Methods: A total of 151 chronic renal failure patients on haemodialysis from May 2003 to October 2004 were studied. One hundred patients out of 151 were followed for 2-5 months. All the patients were tested for anti HCV and HCV core antigen once a month. Anti HCV ELISA positive specimens were confirmed by RIBA. Results: The overall prevalence of HCV infection was 13.23%. Antibody positivity was observed in 9.93% and HCVcAg alone was detected in 2.64%. One patient (0.66%) was initially positive for core antigen and later seroconverted. Conclusions: Screening for HCV antibodies alone does not exclude infection with HCV in patients on haemodialysis and HCVcAg may be a useful test for identifying HCV infected patients on haemodialysis in the early phase of infection before seroconversion.
  10 7,590 464
CASE STUDY
Cutaneous Larva Migrans - A Case Report
L Padmavathy, LL Rao
April-June 2005, 23(2):135-136
DOI:10.4103/0255-0857.16057  PMID:15928447
Cutaneous larva migrans or creeping eruption is an uncommon parasitic skin infection caused by the filariform larvae of dog or cat hook worms. We report a case of larva migrans on the anterior abdominal wall, in a 52 year old lady, who did gardening as a hobby.
  9 9,263 225
Mycobacterium fortuitum Bacteraemia in an Immunocompromised Patient
M Unni, MV Jesudason, S Rao, B George
April-June 2005, 23(2):137-138
DOI:10.4103/0255-0857.16058  PMID:15928448
A case of Mycobacterium fortuitum bacteraemia in an immunocompromised patient confirmed by four positive serial blood cultures is reported here. The patient was a known case of acute lymphoblastic leukemia (ALL) on intensive chemotherapy. The source of bacteraemia was most probably a peripherally inserted vascular catheter. After initiation, of treatment with amikacin to which the strain was sensitive and clarithromycin and removal of the central line the patient's fever defervesced and repeat blood cultures were negative. This is the first time we have encountered an immunocompromised patient with M. fortuitum septicaemia in our hospital. The possibility of an infection with rapidly growing mycobacteria is important to consider when conventional organisms are not isolated in culture especially in the context of patients with malignancy.
  8 8,632 239
ORIGINAL ARTICLE
Inhibition of Bacterial Adhesion by Subinhibitory Concentrations of Antibiotics
KC Vidya, PS Mallya, PS Rao
April-June 2005, 23(2):102-105
DOI:10.4103/0255-0857.16048  PMID:15928438
Background: Urinary Tract Infections (UTIs) due to Escherichia coli is one of the most common diseases encountered in clinical practice. Most common recognised pathogenic factor in E.coli is adhesion. There is accumulating evidence that through subinhibitory concentrations (sub - MICs) of many antibiotics do not kill bacteria, they are able to interfere with some important aspects of bacterial cell function. Materials and Methods: A study was conducted to investigate the effect of sub MICs (1/2-1/8 MIC) of ciprofloxacin, ceftazidime, gentamicin, ampicillin and co - trimoxazole on E. coli adhesiveness to human vaginal epithelial cells using three strains ATCC 25922, MTCC 729 and U 105. Results: The 1/2 MIC of all the antibiotics tested produced the greatest inhibition of bacterial adhesion. Morphological changes were observed with ciprofloxacin, ceftazidime and ampicillin at 1/2 MIC and to a lesser extent at 1/4 and 1/8 MIC. Co-trimoxazole caused the greatest suppression of adhesion at 1/2 MIC of E. coli strain MTCC 729 when compared with the controls, followed by ceftazidime. Conclusion: These results suggest that co - trimoxazole is the most effective antibiotic in the treatment of urinary tract infections caused by uropathogenic E. coli.
  8 8,443 301
CORRESPONDENCE
Prevalence of Non-Keratinophilic Fungi in the Soil
GR Kumari, S Mahrora, PS Rao
April-June 2005, 23(2):144-145
DOI:10.4103/0255-0857.16063  PMID:15928453
  6 5,879 138
CASE STUDY
Candida tropicalis causing Prosthetic Valve Endocarditis
PA Nagaraja, T Mathew, DP Shetty
April-June 2005, 23(2):139-140
DOI:10.4103/0255-0857.16059  PMID:15928449
The incidence of endocarditis produced by the so-called "opportunists" as a complication of prosthetic valve surgery is progressively increasing in frequency and gradually transforming the clinical picture habitually associated with this disease. Candida endocarditis is an unusual but severe complication caused by Candida albicans or other fungal species. This case and a review of the literature indicate that Candida endocarditis treated with amphotericin B and prosthetic valve replacement may recur months after treatment, and that late recurrent Candida endocarditis, which is difficult to diagnose and treat, may be best prevented by lifelong antifungal suppressive therapy.
  5 8,066 219
BRIEF COMMUNICATION
Evaluation of Biphasic Culture System for Mycobacterial Isolation from the Sputum of Patients with Pulmonary Tuberculosis
M Ghatole, C Sable, P Kamale, S Kandle, V Jahagirdar, V Yemul
April-June 2005, 23(2):111-113
DOI:10.4103/0255-0857.16050  PMID:15928440
Mycobacterial diseases continue to cause high morbidity and mortality. Isolation, identification and sensitivity testing form the backbone of laboratory investigations. M. tuberculosis isolation needs 6-8 weeks on conventional egg containing media. For rapid isolation various methods have been evaluated. We evaluated biphasic system (Middlebrook 7H11 agar slant + Middlebrook 9H broth) in comparison with Lowenstein - Jensen (LJ) medium. In smear positive cases biphasic system showed the recovery rate of 97.05% as against 79.41% on LJ on incubation for 21 4.44 and 283.76 days respectively. In smear negative and culture positive cases biphasic system and LJ showed isolation rates of 91.66% and 66.6% after 363.44 and 41 4.09 days respectively. Biphasic system showed lower contamination rate (1.33%). Biphasic medium is superior to LJ medium in isolation of M. tuberculosis .
  4 6,946 242
CORRESPONDENCE
Need for Routine Screening of HBV and HDV in Patients with Cirrhosis of the Liver
P Gupta, D Biswas, I Shukla, A Bal
April-June 2005, 23(2):141-142
DOI:10.4103/0255-0857.16060  PMID:15928450
  3 4,284 135
Rapid Immunochromatographic Test for Syphilis
N Goel, M Sharma, N Gupta, R Sehgal
April-June 2005, 23(2):142-143
DOI:10.4103/0255-0857.16061  PMID:15928451
  3 8,381 277
Coinfection of HSV with other Sexually Transmitted Diseases
BP Peters, VL Rastogi, Monica , PS Nirwan
April-June 2005, 23(2):143-144
DOI:10.4103/0255-0857.16062  PMID:15928452
  2 5,876 178
BRIEF COMMUNICATION
Efficacy of Sonicated and Acid-Extractable Antigens in the Serodiagnosis of H. pylori infection in Peptic Ulcer Patients
N Parimala, M Ishaq
April-June 2005, 23(2):117-119
DOI:10.4103/0255-0857.16052  PMID:15928442
Helicobacter pylori is implicated in causation of peptic ulcers and gastric cancer and plays a pivotal role in gastric pathophysiology. In the present study we evaluated the relative efficacy of sonicated and acid-extractable antigens in the serodiagnosis of H. pylori infection in peptic ulcer patients by ELISA. In the present study we evaluated the relative efficacy of sonicated and acid-extractable antigens in the serodiagnosis of H. pylori infection in peptic ulcer patients by ELISA. The two types of antigens mentioned above were prepared from H. pylori subcultures following appropriate procedures. Sera were collected from 13 subjects of whom eight were diagnosed to be suffering from duodenal ulcer (DU) and five from non-ulcer dyspepsia (NUD) and screened for the presence of anti H. pylori antibodies by ELISA. A case was considered seropositive, if the OD value was more than or equivalent to twice the mean OD value of blank. Analysis of our results showed that, with acid extractable antigen at a concentration of 2 mg/mL, 12 cases were seropositive. Contrastingly, with sonicated antigen, at a concentration of 2 mg/mL only eight cases were positive. It is concluded from this study, that the use of relatively purified antigens like acid extractable antigens enhances the sensitivity and specificity of this serodiagnostic test, indicative of its relatively higher efficacy over sonicated lysate containing multiple antigens.
  - 5,203 146
CORRESPONDENCE
Evaluation of Crystal Violet Blood Agar for Primary Isolation and Identification of Group A-beta haemolytic streptococci
T Menon, B Malathy
April-June 2005, 23(2):145-145
DOI:10.4103/0255-0857.16064  PMID:15928454
  - 5,317 163
Author's Reply
K Chawla
April-June 2005, 23(2):146-146
PMID:15928455
  - 2,917 81
EDITORIAL
Recent Avian Influenza Outbreaks: A Pandemic in the Waiting
S Broor
April-June 2005, 23(2):72-73
DOI:10.4103/0255-0857.16043  PMID:15928433
  - 7,986 211

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

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