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   2005| October-December  | Volume 23 | Issue 4  
 
 
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BRIEF COMMUNICATIONS
Surgical site infection in clean and clean-contaminated cases
SP Lilani, N Jangale, A Chowdhary, GB Daver
October-December 2005, 23(4):249-252
PMID:16327121
The rate of surgical site infections and the frequency of various pathogens causing surgical site infection with their antibiotic resistance pattern in general surgery units were studied. In the period from May 2001 to July 2002, 190 patients admitted for surgery (clean and clean-contaminated elective cases) were assessed preoperatively, intraoperatively and postoperatively. Normal microbial flora was studied within 24 to 48 hours of admission and patients were followed up to 30 days postoperatively. Infected wounds were studied bacteriologically and clinically. The overall infection rate was 8.95%. Surgical site infection rate was 3.03% in clean surgeries and 22.41% in clean-contaminated surgeries. Significant increase was seen in surgical site infection rate with an increase in preoperative stay. The increase in duration of surgery was associated with a significant rise in the rate of surgical site infection. Surgical site infection rate was much higher (22.41%) in cases where a drain was used than in non-drained wounds (3.03%). The most common isolate was Staphylococcus aureus followed by Pseudomonas aeruginosa .
  23,339 989 28
REVIEW ARTICLE
Enterococcal resistance - An overview
YA Marothi, H Agnihotri, D Dubey
October-December 2005, 23(4):214-219
PMID:16327115
Nosocomial acquisition of microorganisms resistant to multiple antibiotics represents a threat to patient safety. Here, we review the antimicrobial resistance in Enterococcus , which makes it important nosocomial pathogen. The emergence of enterococci with acquired resistance to vancomycin has been particularly problematic as it often occurs in enterococci that are also highly resistant to ampicillin and aminoglycoside thereby associated with devastating therapeutic consequences. Multiple factors contribute to colonization and infection with vancomycin resistant enterococci ultimately leading to environmental contamination and cross infection. Decreasing the prevalence of these resistant strains by multiple control efforts therefore, is of paramount importance.
  16,997 1,634 30
ORIGINAL ARTICLE
Cysticercosis of the eye in south India - A case series
S Kaliaperumal, VA Rao, SC Parija
October-December 2005, 23(4):227-230
PMID:16327117
Purpose: To study the clinical presentation and treatment outcome of patients with ocular cysticercosis in southern India. Methods: This study included 10 patients who were diagnosed to have ocular or adnexal cysticercosis over a period of one year in Pondicherry, India. The clinical presentation, results of investigation and treatment outcome of the cases were analysed retrospectively. Results: Age of these patients ranged from 12 to 55 years. Four presented with loss of vision, two with a swelling in the eyelid, one with proptosis, one with diplopia and two with conjunctival involvement. ELISA for cysticercus antibodies in serum was positive in all cases. Albendazole and prednisolone were given for the treatment of these cases. Two patients responded well to treatment and were completely cured of the disease. There was partial improvement in 6 cases. Surgery in the form of excision was performed in two cases following a course of medical therapy. There was no significant change in visual acuity in eyes with intraocular cysticercosis following treatment. Conclusion: Ultrasonography B scan and ELISA for anticysticercal antibodies help to establish the diagnosis of ocular cysticercosis. A combination of oral albendazole and corticosteroids is found to be effective in confirmed cases. Intraocular cysticercosis is associated with a poor prognosis for vision.
  14,782 518 14
Granulomatous inflammation in acanthamoeba keratitis: An immunohistochemical study of five cases and review of literature
GK Vemuganti, G Pasricha, S Sharma, P Garg
October-December 2005, 23(4):231-238
PMID:16327118
Purpose: Acanthamoeba keratitis usually presents as a necrotizing stromal inflammation. We report a rare presentation of granulomatous inflammation in Acanthamoeba keratitis Methods: Retrospective clinico-pathologic case series. Results: Five corneal tissues (3 corneal buttons, 2-eviscerated contents) from patients suffering from severe Acanthamoeba keratitis not responding to anti-Acanthamoeba treatment, revealed a florid granulomotous inflammation with multinucleated giant cells in the posterior stroma and around Descemet's membrane. Phagocytosed parasites were noted within the giant cells. Vascularization of the corneal stroma was noted in two cases. Immunophenotyping revealed a predominance of T lymphocytes and macrophages. Clinically, four of five cases had shown features of limbal and scleral involvement. Conclusion: Granulomatous inflammation in the posterior corneal stroma, is not an uncommon finding in Acanthamoeba keratitis and could possibly be immune-mediated, contributing to persistence and progression of disease. Clinical Relevance: Presence of granulomatous inflammation in Acanthamoeba keratitis, in most cases is associated with limbal and scleral involvement and therefore could be considered as one of the poor prognostic markers. Further studies are required to ascertain the specific clinical features and appropriate management strategies in these cases.
  12,966 291 4
SPECIAL ARTICLE
Blood culture in India: A proposal for a national programme for early detection of sepsis
S Bhattacharya
October-December 2005, 23(4):220-226
PMID:16327116
Septicaemia is a major contributor of mortality. Blood culture is the essential investigation for the management of sepsis. Due to lack of resources blood culture is an irregularly used investigation in India. A three-tier level of development is being proposed to develop the blood culture based national programme for early detection of sepsis. The plan envisages the establishment of manual blood culture based elementary system in the health centre and district hospital level (Level 1), direct Gram stain and direct antibiotic sensitivity testing from the "positive" blood culture broths at the medical college hospital level (Level 2) and development of automated methods, enhancement of quality control and safety measures, clinical liaison and re-orientation of microbiology training at the tertiary care centre level (Level 3).
  11,301 710 1
CASE REPORTS
Human babesiosis - A case report
A Marathe, J Tripathi, V Handa, V Date
October-December 2005, 23(4):267-269
PMID:16327127
Babesiosis is an emerging, tick-transmitted, zoonotic disease caused by hematotropic parasites of the genus Babesia. Most cases of Babesial infections in humans have been acquired in temperate regions of the United States, Europe, France and England. A few cases of Babesiosis have been described in other parts of the world, including China, Taiwan, Egypt, South Africa, and Mexico.1,2 We report the first case of human Babesiosis, in a normosplenic, previously healthy individual from India.
  11,561 387 15
Ecthyma gangrenosum: A rare cutaneous manifestation caused by pseudomonas aeruginosa without bacteraemia in a leukaemic patient- A case report
TN Singh, KM Devi, KS Devi
October-December 2005, 23(4):262-263
PMID:16327125
Ecthyma gangrenosum is a rare and invasive cutaneous infection caused by Pseudomonas aeruginosa in the majority of cases, typically affecting immunocompromised patients, particularly those with neutropenia. We report a rare case of ecthyma gangrenosum in the absence of bacteraemia presenting as a solitary necrotic ulcer in a female patient with acute lymphoblastic leukaemia. A culture from the ecthyma lesion revealed the presence of Pesudomonas aeruginosa , but the results of repeated blood cultures were negative. The patient responded well to amikacin to which the isolate was susceptible in vitro . Considering high rate of mortality, early diagnosis and prompt effective treatment is mandatory.
  11,581 343 10
BRIEF COMMUNICATIONS
Sterilisation of extracted human teeth for educational use
M Kumar, PS Sequeira, S Peter, GK Bhat
October-December 2005, 23(4):256-258
PMID:16327123
Sixty intact, non-carious and unrestored teeth extracted due to periodontal disease were used to determine the most effective method of sterilisation. The teeth were divided into six groups, each containing 10 teeth. Group 1 teeth were immersed in 10% formalin for seven days, group 2 teeth were immersed in 3% hydrogen peroxide for seven days, group 3 teeth were immersed in 2.6% sodium hypochlorite for seven days, group 4 teeth were boiled in water at 100C for 20 minutes, group 5 teeth were autoclaved at 121C at 15 lbs psi for 30 minutes, and group 6 teeth were immersed in normal saline for seven days. After the treatment, the teeth were individually inoculated into trypticase soy broth and incubated for 48 hours. A questionnaire survey was also conducted to determine the awareness of dental students regarding infection due to extracted human teeth and the common disinfection/sterilisation methods used. Autoclaving at 121C, 15 lbs psi for 30 minutes and immersion in 10% formalin for seven days were effective in disinfecting/sterilising extracted human teeth. Chemicals such as 2.6% sodium hypochlorite, 3% hydrogen peroxide and boiling in water were not effective. The results indicate that autoclaving for 30 minutes or immersion in 10% formalin for seven days could be effectively used for disinfection/sterilisation of extracted human teeth.
  9,846 348 4
ORIGINAL ARTICLE
Comparison of various microbiological tests including polymerase chain reaction for the diagnosis of osteoarticular tuberculosis
SS Negi, S Gupta, S Khare, S Lal
October-December 2005, 23(4):245-248
PMID:16327120
Purpose: To evaluate the utility of the polymerase chain reaction(PCR) test for diagnosing osteoarticular tuberculosis (TB). Methods: Clinical samples (synovial tissue and synovial fluid) obtained from 23 cases of suspected osteoarticular tuberculosis were subjected to Ziehl Neelsen (ZN) smear examination, radiometric BACTEC culture and PCR test for tuberculosis by amplifying 65 kDa antigen coding region of Mycobacterium tuberculosis ( M.tb ) genome. Results: PCR test was found to be much sensitive than the ZN smear examination and BACTEC culture(p < 0.05) in the diagnosis of osteoarticular TB. In synovial fluid samples, PCR was positive in 73.9%, ZN smear examination in 17.39% and BACTEC culture in 39.13% of cases.The positivities were relatively lower with synovial tissue samples, the corresponding figures being 60.8, 8.6 and 26.08% respectively. Moreover, on combining the results of synovial fluid and tissues, the corresponding figures further increased to 78.2, 21.7 and 43.3% respectively. Further, sensitivity and specificity for PCR employing BACTEC culture as the "gold standard" was 100 and 83.3% respectively. Using BACTEC culture, the earliest positivity was seen in three days using synovial tissue specimen and 13 days with synovial fluid, the average detection times being 23.2 days and 32.6days respectively. On the other hand, PCR test gave a positive result within 24 hours.Conclusions: PCR test was shown to be much more sensitive than ZN smear examination and BACTEC culture test for diagnosing osteoarticular tuberculosis.
  7,995 454 12
Application of polymerase chain reaction to differentiate herpes simplex virus 1 and 2 serotypes in culture negative intraocular aspirates
G Shyamala, P Sowmya, B Sudha, J Malathi, LK Therese, HN Madhavan
October-December 2005, 23(4):239-244
PMID:16327119
Purpose: To standardize and apply a polymerase chain reaction (PCR) on the glycoprotein D gene to differentiate Herpes simplex virus (HSV) 1 & 2 serotypes in culture negative intraocular specimens. Methods: Twenty-one intraocular fluids collected from 19 patients were subjected to cultures for HSV and uniplex PCR (uPCR) for DNA polymerase gene. To differentiate HSV serotypes, as 1 & 2, a seminested PCR (snPCR) targeting the glycoprotein D gene was standardised and applied onto 21 intraocular fluids. The specificity of the snPCR was verified by application onto ATCC strains of HSV 1 and 2, clinical isolates and DNA sequencing of the amplified products. All specimens were also tested for the presence of cytomegalovirus (CMV) and varicella zoster virus (VZV) by nucleic acid amplification methods. Results: Four of the 21 intraocular fluids were positive for HSV by uPCR. snPCR detected HSV in three additional specimens (total of seven specimens), and identified three as HSV 1 and four as HSV 2. DNA sequencing of PCR products showed 100% homology with the standard strains of HSV 1 and 2 respectively. None of the samples were positive in culture. Among the other patients, CMV DNA was detected in two and VZV DNA in five others. Conclusions: The standardized snPCR can be applied directly onto the culture negative specimens for rapid differentiation of HSV serotypes.
  8,049 342 4
CASE REPORTS
Haemophilus aphrophilus brain abscess in the first decade
M Bayraktar, C Onal, B Durmaz, C Yakinci, E Sonmezgoz
October-December 2005, 23(4):259-261
PMID:16327124
This report presents a case of brain abscess due to Haemophilus aphrophilus in a six-year old boy. He was admitted to our hospital suffering from left-sided weakness. The initial radiological diagnosis was an intracranial abscess. Purulent material was obtained by puncturing the subcortical lesion and the sample was cultured on conventional media. H. aphrophilus was isolated in pure culture, identified according to conventional methods and confirmed by Becton Dickinson Laboratory (BBL) crystal system. After surgical drainage and eight weeks of antibiotic therapy, the neurological findings improved. The presented case is an example of H. aphriphilus causing brain abscess in the first decade without cardiac predisposition and with good outcome.
  8,016 197 -
CORRESPONDENCE
Incubation period for culture positivity to detect septicaemia in neonates
CS Vinod Kumar, YF Neelagaud
October-December 2005, 23(4):270-271
PMID:16327128
  5,685 275 4
Strengthening microbial forensics to counter bioterrrorism
P Pattnaik
October-December 2005, 23(4):271-272
PMID:16327129
  5,695 226 -
CASE REPORTS
Prosthetic valve endocarditis caused by scedosporium apiospermum
S Verghese, P Padmaja, MT Chellamma, S Leelavathy, P Nayar
October-December 2005, 23(4):264-266
PMID:16327126
Scedosporium apiospermum , the asexual state of Pseudallescheria boydii , is increasingly recognized as an opportunistic pathogen. We report a case of prosthetic valve endocarditis caused by this organism that developed in a patient following cardiac surgery.
  5,656 170 5
CORRESPONDENCE
Prevalence of hepatitis C and B viral markers in patients with chronic liver disease: A study from Northern India
A Chakravarti, V Verma
October-December 2005, 23(4):273-274
PMID:16327131
  5,325 321 3
Evaluation of paraffin baiting technique for rapid isolation of atypical mycobacteria
H Kaur, A Oberoi
October-December 2005, 23(4):272-273
PMID:16327130
  5,001 185 2
EDITORIAL
Better reporting of studies of diagnostic accuracy
M Pai, S Sharma
October-December 2005, 23(4):210-213
PMID:16327114
  5,032 152 1
BRIEF COMMUNICATIONS
In vitro resistance to human platelet microbicidal protein among urethral staphylococcal and enterococcal isolates with its correlation with prostatitis
IB Ivanov
October-December 2005, 23(4):253-255
PMID:16327122
The study was carried out to test the in vitro activity of human platelet microbicidal protein (hPMP) on most commonly isolated urethral pathogens and compare the same with clinical isolates from cases of chronic prostatitis (CP). Urethral isolates of Staphylococcus aureus (n=19), coagulase negative staphylococci (n=40) and Enterococcus faecalis (n=16) from patients with or without CP were tested. The hPMP susceptibility of bacterial strains was determined by exposing bacterial cells to serial dilutions of hPMP. A significantly higher proportion of CP-strains of coagulase negative staphylococci (91.3% vs 5.88%) was resistant to hPMP than was that of non-CP strains (P < 0.001). Among CP-strains of S.aureus studied, 77.8% were considered resistant to the bactericidal action of hPMP. All nine CP-strains of E.faecalis were highly resistant to hPMP. Most non-CP urethral isolates of S.aureus , coagulase negative staphylococci and E.faecalis were susceptible to the bactericidal action of hPMP, while CP isolates of all species were significantly more resistant to hPMP. Data from the present study may have significant implications in understanding the pathogenesis of CP.
  4,985 146 6
CORRESPONDENCE
Should bacitracin sensitivity be used in the presumptive identification of group a streptococci?
T Menon, C Lloyd, S Jacob
October-December 2005, 23(4):275-275
PMID:16327133
  4,631 185 -
Immunity against measles among vaccinated school going children in Zahedan, Southeast of Iran
BS Mood, RN Naini, M Salehi, HR Kouhpayeh, TM Azad, TN Poor
October-December 2005, 23(4):274-275
PMID:16327132
  4,316 113 2

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

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