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   2008| July-September  | Volume 26 | Issue 3  
    Online since July 22, 2008

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Surface disinfection by exposure to germicidal UV light
G Katara, N Hemvani, S Chitnis, V Chitnis, DS Chitnis
July-September 2008, 26(3):241-242
DOI:10.4103/0255-0857.42034  PMID:18695322
The present study was aimed to design a simple model to check efficacy of germicidal UV tube, to standardise the position, distance and time for UV light and also to find out its efficacy against medically important bacteria, the bacterial spores and fungi. The microbial cultures tested included gram positive and gram negative bacteria, bacterial spores and fungal spores. The microbes streaked on solid media were exposed to UV light. The inactivation of the order of four logs was observed for bacteria. UV light can have efficient inactivation of bacteria up to a distance of eight feet on either side and exposure time of 30 minutes is adequate.
  16,919 541 8
An evaluation of four different phenotypic techniques for detection of metallo-β-lactamase producing Pseudomonas aeruginosa
B Behera, P Mathur, A Das, A Kapil, V Sharma
July-September 2008, 26(3):233-237
DOI:10.4103/0255-0857.39587  PMID:18695320
Purpose: The present study was undertaken to detect metallo-β-lactamase (MBL) in nosocomial isolates of Pseudomonas aeruginosa by four different phenotypic methods. Methods: Ninety-one consecutive P. aeruginosa isolates were subjected to susceptibility testing by disc-diffusion assay and Vitek 2. Imipenem resistance was determined by three different methods (disc-diffusion, Vitek 2 and E test). Screening for MBL production was done by imipenem-EDTA combined disc test, imipenem-EDTA double-disc synergy test, imipenem-EDTA MBL E test and EDTA disc potentiation using four cephalosporins. Results: Of 63 imipenem resistant isolates, MBL screening could be done in 56 isolates, of which 48 were MBL positive by combined disc test and 36 by the double disc synergy test. For confirmation of MBL production, MBL E test was done in 30 isolates. All the 30 isolates were confirmed to be MBL positive by the MBL E test method. EDTA disc potentiation using four cephalosporins was not very useful for MBL detection. Conclusions: Imipenem-EDTA combined disc test and imipenem-EDTA MBL E test are equally effective for MBL detection, but given the cost-constraints, combined disc test can be used as a convenient screening method in the clinical microbiology laboratory.
  13,787 1,849 31
Comparison of ELISA and rapid screening tests for the diagnosis of HIV, hepatitis B and hepatitis C among healthy blood donors in a tertiary care hospital in Mumbai
VP Torane, JS Shastri
July-September 2008, 26(3):284-285
DOI:10.4103/0255-0857.42071  PMID:18695340
  14,435 596 9
Infections in traumatised patients: A growing medico-surgical concern
P Mathur
July-September 2008, 26(3):212-216
DOI:10.4103/0255-0857.42030  PMID:18695316
Accidents and trauma are a leading global cause of mortality in young adults. Infections are one of the most important causes of death in traumatized patients. This is because of factors related to host and those due to trauma itself. Trauma jeopardizes the host's tissue integrity and immune effector mechanisms. Severely traumatized patients admitted to the ICUs are prone to get nosocomial infections due to open wounds and indwelling life saving devices. Massive blood loss also impairs the distribution of polymorphs, complement and antibiotics to the damaged tissues. Finally, diagnosis of infections in traumatized patients poses a challenge to clinicians due to various factors.
  12,625 734 3
Evaluation of rapid MTT tube method for detection of drug susceptibility of mycobacterium tuberculosis to rifampicin and isoniazid
U Raut, P Narang, DK Mendiratta, R Narang, V Deotale
July-September 2008, 26(3):222-227
DOI:10.4103/0255-0857.39586  PMID:18695318
Purpose: To evaluate MTT method for detection of drug resistance to rifampicin and isoniazid in M.tuberculosis . This method utilises the ability of viable mycobacterial cells to reduce MTT( 3-4,5-dimethylthiazol-2-yl-2, 5-diphenyl tetrazolium bromide). Methods: The method was standardised with known resistant and sensitive strains of M.tuberculosis and was then extended to 50 clinical isolates. An inoculum of 10 7 cfu/mL was prepared in Middlebrook 7H9 medium supplemented with oleic acid, albumin, dextrose and catalase. For each drug three tubes were used, one with INH(0.2μg/mL) or RIF(1μg/mL), another as inoculum control and third as blank control. These were incubated at 37C for four and seven days respectively for RIF and INH after which MTT assay was performed. Results were read visually and by colorimeter at 570 nm. Relative optical density unit (RODU) of 0.2 was taken as cut off. Results were compared with drug sensitivity obtained by proportion method using LJ medium. Results: For rifampicin, concordance with proportion method was 90% by visual and 94% by RODU. Sensitivity and specificity was 86.8% and 100% respectively by visual method and 95.2% and 87.5% respectively by RODU. For Isoniazid, concordance was 94% and sensitivity and specificity was 94.7 and 91.7% respectively by both visual and RODU. Conclusions: MTT assay proved to be rapid and cheap method for performing drug sensitivity of M.tuberculosis
  8,568 674 16
Prevalence of inducible clindamycin resistance in gram positive organisms in a tertiary care centre
MR Angel, V Balaji, JAJ Prakash, KN Brahmadathan, MS Mathews
July-September 2008, 26(3):262-264
DOI:10.4103/0255-0857.42041  PMID:18695329
Gram positive organisms are one of the leading pathogens causing skin and soft tissue infections. For these infections, clindamycin is a useful alternate drug in penicillin-allergic patients. This study was conducted to investigate the prevalence of erythromycin-induced clindamycin resistance in gram positive organisms in the southern part of the country. A total of 522 consecutive clinical isolates from blood, CSF, sputum, throat, pus, and urine were collected between November 2006 and April 2007 and tested for erythromycin resistance and inducible clindamycin resistance. There was a relatively higher incidence of inducible clindamycin resistance among the MRSA isolates. We conclude, therefore, that clindamycin is not a suitable alternative antibiotic for use in staphylococcal skin and soft tissue infections.
  7,625 649 31
Metallo-β-lactamase-producing clinical isolates of Acinetobacter species and Pseudomonas aeruginosa from intensive care unit patients of a tertiary care hospital
S Irfan, A Zafar, D Guhar, T Ahsan, R Hasan
July-September 2008, 26(3):243-245
DOI:10.4103/0255-0857.42035  PMID:18695323
Prompt detection of metallo-β-lactamase (MBL) producing isolates is necessary to prevent their dissemination. Frequency of MBLs producing strains among multidrug resistant (MDR) Acinetobacter species and Pseudomonas aeruginosa was evaluated in critical care patients using imipenem-EDTA disk method. One hundred MDR Acinetobacter spp. and 42 Pseudomonas aeruginosa were checked for MBL production, from January to June 2001. MBL was produced by 96.6 % of imipenem-resistant Acinetobacter isolates, whereas 100% imipenem-resistant Pseudomonas aeroginosa isolates were MBL producers. Carbapenem resistance in MDR Acinetobacter spp. and Pseudomonas aeruginosa isolates in this study was due to MBLs. This calls for strict infection control measures to prevent further dissemination.
  7,158 1,102 8
Basidiobolomycosis: A rare case report
R Singh, I Xess, AS Ramavat, R Arora
July-September 2008, 26(3):265-267
DOI:10.4103/0255-0857.42044  PMID:18695330
We report a rare case of basidiobolomycosis seen in an 11-year-old girl from North-Eastern part of India. She presented with complaints of bilateral nasal block and nasal discharge for seven-eight months. CT scan of sinuses revealed polypoidal mass in all the sinuses with extradural extension. The tissue biopsy examined histopathologically and microbiologically, revealed Basidiobolus ranarum
  6,462 322 5
Existence of proviral porcine endogenous retrovirus in fresh and decellularised porcine tissues
S Prabha, S Verghese
July-September 2008, 26(3):228-232
DOI:10.4103/0255-0857.42032  PMID:18695319
Purpose: Swine are expected to be utilized as xenograft donors for both whole organ and cellular transplantation. A major concern in using porcine organs for transplantation is the potential of transmission of porcine endogenous retrovirus (PERV). Tissue-engineered or decellularised heart valves have already been implanted in humans and have been marketed by certain companies after Food and Drug Administration (FDA) approval. The aim of this study was to examine the existence of porcine endogenous retrovirus (PERV) in fresh and decellularised porcine tissues. Methods: Porcine tissues (both fresh and decellularised) were analysed using validated assays specific for PERV: polymerase chain reaction (PCR), reverse transcriptase polymerase chain reaction (RT-PCR). Results: PERV specific GAG sequences were found in the porcine heart tissue samples using PCR for DNA and RT- PCR for RNA. All tissue samples (both fresh and treated tissues) like aortic valve, pulmonary valve and heart muscle showed the presence of PERV DNA. RT PCR for PERV was positive in all fresh tissues and was found to be negative in decellularised treated tissues. Conclusions: PCR is a rapid, specific test for the detection of PERV virus in xenografts. These findings have demonstrated that the presence of proviral DNA form of PERV in porcine tissues needs to be carefully considered when the infectious disease potential of xenotransplantation is being assessed.
  6,026 293 4
Brain abscess caused by Cladophialophora Bantiana in an immunocompetent host: Need for a novel cost-effective antifungal agent
SA Borkar, MS Sharma, G Rajpal, M Jain, I Xess, BS Sharma
July-September 2008, 26(3):271-274
DOI:10.4103/0255-0857.42050  PMID:18695333
We report a 53-year-old male who presented with headache, tremor and memory disturbance. Radiological evaluation was suggestive of brain abscess. He underwent gross total excision of the cerebral abscess. The histopathological examination and pus culture was suggestive of brain abscess caused by Cladophialophora bantiana. Authors report a rare case of biopsy and culture proven Cladophialophora bantiana brain abscess in an immunocompetent host. The authors review the relevant literature and current treatment options while emphasizing the need for a cost-effective novel antifungal drug to salvage a subset of patients suffering from this rare but increasingly frequent condition.
  5,870 292 6
Evidence for lower CD4+ T cell and higher viral load in asymptomatic HIV-1 infected individuals of India: Implications for therapy initiation
R Kannangai, AJ Kandathil, DL Ebenezer, G Nithyanandam, P Samuel, OC Abraham, TD Sudarsanam, SA Pulimood, G Sridharan
July-September 2008, 26(3):217-221
DOI:10.4103/0255-0857.42031  PMID:18695317
Purpose: We have earlier documented that the south Indian population had lower CD4 counts. The aim of this study was to investigate a previous suggestion on a new CD4+ T cell cut off and association with HIV-1 RNA levels for decision on anti retroviral therapy in India (south). Methods: We evaluated a new methodology i.e., artus real-time PCR and CD4+ T cell count by Guava EasyCD4 system. From 146 HIV infected individuals seen at a tertiary care centre, blood was collected for CD4+ T cell and HIV-1 RNA estimation. Results: The receiver operating characteristic curve cut off value for the CD4 counts to distinguish between CDC clinical categories A and B was 243 cells/μL, and to distinguish B and C was 153 cells/μL. The RNA level that differentiated CDC A and B was 327473 RNA copies/mL, while for CDC B and C was 688543 copies/mL. There was a significant negative correlation (r = -0.55, P < 0.01) between the RNA estimated and CD4+ T cell counts in HIV infected individuals. Conclusions: A majority with CD4 counts of 201-350 cells/μL in our population had higher viral load than the treatment threshold suggested by the International AIDS society and the above two methodologies are useful in monitoring HIV infections.
  5,560 540 9
Mycobacterial culture of fine needle aspirate - A useful tool in diagnosing tuberculous lymphadenitis
VC Kishore Reddy, S Aparna, CE Prasad, A Srinivas, B Triveni, S Gokhale, KV Krishna Moorthy
July-September 2008, 26(3):259-261
DOI:10.4103/0255-0857.42040  PMID:18695328
A prospective study was undertaken on suspected lymph node TB (LNTB) patients, to evaluate the diagnostic utility of mycobacterial culture of fine needle aspirate (FNA), in comparison with the cytological examination and acid fast staining. Eighty percent of 157 aspirates studied were positive by cytological examination; 18% by ZN smear and 45% were positive by culture. Twelve aspirates which were negative by cytological features yielded positive mycobacterial cultures; four out of these were from HIV positive patients. Our observations suggest that supplementing FNA cytology with mycobacterial culture would increase the sensitivity of diagnosing LNTB; in addition to giving a highly specific diagnosis.
  5,666 421 5
Abnormal morphology of bacteria in the cerebrospinal fluid of a patient on antibiotics
R Mani, S Nagarathna, A Chandramuki
July-September 2008, 26(3):283-284
DOI:10.4103/0255-0857.42060  PMID:18695339
  5,670 231 -
Scaling up anti-mycobacterial drug susceptibility testing services in India: It is high time
S Singh
July-September 2008, 26(3):209-211
DOI:10.4103/0255-0857.42029  PMID:18695315
  5,102 648 8
Extended spectrum beta lactamase (ESBL) producing Escherichia coli and klebsiella pneumoniae in diabetic foot infection
A Varaiya, J Dogra, M Kulkarni, P Bhalekar
July-September 2008, 26(3):281-282
DOI:10.4103/0255-0857.42056  PMID:18695337
  5,163 585 5
Incidence of carbapenem-resistant Pseudomonas aeruginosa in diabetes and cancer patients
A Varaiya, M Kulkarni, P Bhalekar, J Dogra
July-September 2008, 26(3):238-240
DOI:10.4103/0255-0857.42033  PMID:18695321
Two hundred and thirty isolates of Pseudomonas aeruginosa were obtained from samples of patients having diabetes (75%), cancer (20%), and both diabetes and cancer (5%) who were admitted to a tertiary care hospital in Western India from January to December 2006. These isolates were tested for susceptibility to antipseudomonal drugs and considered to be resistant to carbapenem when the zone of inhibition around imipenem and meropenem discs was ≤13 mm. Of these 230 isolates, 26% were found to be carbapenem resistant. The rapid dissemination of carbapenem resistance is worrisome and calls for the implementation of surveillance studies as well as judicious use of antibiotics.
  5,141 585 4
The prevalence of HBV, HCV and HIV infections among blood donors in Izmir, Turkey
I Afsar, S Gungor, AG Sener, SG Yurtsever
July-September 2008, 26(3):288-289
DOI:10.4103/0255-0857.42074  PMID:18695343
  5,202 389 8
Nocardial brain abscess in an immunocompetent host
M Dias, S Nagarathna, A Mahadevan, BA Chandramouli, A Chandramuki
July-September 2008, 26(3):274-277
DOI:10.4103/0255-0857.42052  PMID:18695334
Nocardial infection of the central nervous system is rare and usually manifests as brain abscess. Here we describe an elderly gentleman who presented with signs and symptoms of an intracranial mass lesion localising to the frontal lobe. Clinical examination and CT scan suggested neoplasia as the probable diagnosis. A biloculated abscess was seen at surgery. Aspiration of the contents and examination of pus revealed Nocardia asteroides . Treatment included total excision and prolonged antibiotic therapy which resulted in an excellent outcome.
  5,178 380 4
CD4 and CD8 reference counts in normal healthy south-Indian adults
PR Shahapur, I Bairy, PG Shivananda
July-September 2008, 26(3):280-281
DOI:10.4103/0255-0857.42055  PMID:18695336
  4,761 260 3
Correlation between baseline CD4 + T-Lymphocyte count and plasma viral load in AIDS patients and their early clinical and immunological response to HAART: A preliminary study
H Gautam, P Bhalla, S Saini, R Dewan
July-September 2008, 26(3):256-258
DOI:10.4103/0255-0857.42039  PMID:18695327
The aim of this study was to determine the clinical, immunological and virological status of newly diagnosed AIDS cases and to monitor their clinical and immunological response to HAART after a minimum period of three months. Forty three drug naive AIDS patients were enrolled. The most common presenting complaints were weight loss (74.4%), cough (72.1%) and diarrhoea (67.4%). Mean baseline CD4 cell count was 112 60 cells/μL and mean baseline plasma viral load of 31 patients studied was 192,686 copies/mL. Baseline plasma viral load was higher among patients with lower baseline CD4 cell count. During follow-up, 80.8% patients showed clinical improvement, while a CD4 cell count increased by ≥50 cells/μL in 84.6% cases. Mean CD4 cell count increased from 126 16.6 cells/μL at baseline to 278 196.7 cells/μL.
  4,602 382 3
Assessment of pheromone response in biofilm forming clinical isolates of high level gentamicin resistant Enterococcus faecalis
S Jayanthi, M Ananthasubramanian, B Appalaraju
July-September 2008, 26(3):248-251
DOI:10.4103/0255-0857.42037  PMID:18695325
Twenty five clinical isolates of high level gentamicin resistant Enterococcus faecalis were tested for their biofilm formation and pheromone responsiveness. The biofilm assay was carried out using microtiter plate method. Two isolates out of the 25 (8%) were high biofilm formers and 19 (76%) and four (16%) isolates were moderate and weak biofilm formers respectively. All the isolates responded to pheromones of E. faecalis FA2-2 strain. On addition of pheromone producing E. faecalis FA2-2 strain to these isolates, seven of 19 (37%) moderate biofilm formers developed into high biofilm formers. Similarly one of the 4 (25%) weak biofilm formers developed into high level biofilm former. Twelve (48%) of the 25 isolates were transconjugated by cross streak method using gentamicin as selective marker. This proves that the genetic factor for gentamicin resistance is present in the pheromone responsive plasmid. Among these twelve transaconjugants, seven isolates and one isolate were high biofilm formers on addition of E. faecalis FA2-2 and prior to its addition respectively. Out of the total 25 isolates, eight transconjugants for gentamicin resistance could turn to high biofilm formers on addition of the pheromone producing strain. All the isolates were resistant to more than two antibiotics tested. All the isolates were sensitive to vancomycin. The results indicate the significance of this nosocomial pathogen in biofilm formation and the role of pheromone responding clinical isolates of E. faecalis in spread of multidrug resistance genes.
  4,248 522 4
Incidence of human herpes virus-6 and human cytomegalovirus infections in donated bone marrow and umbilical cord blood hematopoietic stem cells
A Behzad-Behbahani, M Entezam, A Mojiri, R Pouransari, M Rahsaz, M Banihashemi, T Heidari, A Farhadi, N Azarpira, R Yaghobi, Z Jowkar, M Ramzi, M Robati
July-September 2008, 26(3):252-255
DOI:10.4103/0255-0857.42038  PMID:18695326
This study examined the incidence of human herpes virus-6 (HHV-6) and human cytomegalovirus (HCMV) infections that are potentially transmitted to haematopoietic stem cells (HSC) transplant recipients via bone marrow (BM) or umbilical cord blood (UCB). Bone marrow progenitor cells were collected from 30 allogenic BM donors. UCB HSC were collected from 34 subjects. The extracted DNA was then processed using nested polymerase chain reaction (nPCR) technique. HCMV and HHV-6 serological status were determined by enzyme immunoassay (EIA). Nested PCR identified HCMV in 22 (73%) of 30 samples of BM progenitor cells but in only eight (23.5%) of 34 samples of UBC HSC ( P = 0.001). HHV-6 DNA was detected in 11 (36.6%) of 30 BM progenitor cells and in only one (2.9%) of 34 UBC cells ( P = 0.002). Both HHV-6 and HCMV infections were determined in nine (26.5%) of 34 bone marrow samples. The results indicate that, the risk of HCMV and HHV-6 via BM progenitor cells is higher than transmission by UCB cells ( P= 0.04).
  4,443 288 2
Apophysomyces elegans - renal mucormycosis in a healthy host: A case report from south India
AJ Thomas, S Shah, MS Mathews, N Chacko
July-September 2008, 26(3):269-271
DOI:10.4103/0255-0857.42048  PMID:18695332
Zygomycosis is an opportunistic fungal infection that seldom occurs in individuals with a competent immune system. Isolated involvement of any organ is rare and only a few cases of renal zygomycosis have been reported. We present an unusual case of renal zygomycosis caused by Apophysomyces elegans in a patient with no known predisposing factor. He presented with flakes in the urine and was found to have a poorly functioning right kidney. Ureterorenoscopy was performed, fungal elements removed and pathological confirmation obtained. The patient subsequently underwent nephrectomy after treatment with amphotericin B. He made an uneventful recovery.
  4,344 267 12
Viscoexpression of large free floating cysticercus cyst from the anterior chamber of the eye by double incision technique
S Kai, M Vanathi, S Vengayil, A Panda
July-September 2008, 26(3):277-279
DOI:10.4103/0255-0857.42054  PMID:18695335
We describe a case of 16-year-old girl who reported with diminution of vision in left eye for past seven months with appearance of white reflex. Slit lamp biomicroscopy revealed the presence of a live grayish white cyst in the anterior chamber. The ultrabiomicroscopic evaluation revealed a large live Cysticercus cellulosae cyst in anterior chamber. The CT-scan of the brain revealed multiple non-contrast enhanced lesions with calcification in brain parenchyma. The patient was started on oral prednisolone and oral albendazole. The cyst was removed in toto from the eye by double incision technique. The patient achieved visual acuity of 6/12 post-operatively.
  4,239 190 1
Study of antimicrobial resistance in enterococci
VA Rahangdale, G Agrawal, SV Jalgaonkar
July-September 2008, 26(3):285-287
DOI:10.4103/0255-0857.42072  PMID:18695341
  3,679 595 4
Identification of transmembrane region and orientation of aquaglyceroporin of Plasmodium falciparum
V Wiwanitkit
July-September 2008, 26(3):246-247
DOI:10.4103/0255-0857.42036  PMID:18695324
Aquaglyceroporin is a subclass of aquaporin water channels. This protein is also a focused potential drug target for falciparum malaria. However, the knowledge about the structure of this protein is limited. In this communication, the author performed a study to determine the transmembrane region and orientation of aquaglyceroporin of Plasmodium falciparum . According to this study, six transmembrane regions of aquaglyceroporin of P. falciparum can be identified. These regions can be the focused target for future drug development.
  3,729 238 2
HBV, HCV and syphilis co-infections in human immunodeficiency virus positive Bangladeshi patients: Observation at two reference laboratories
SU Munshi, MM Hoque, MEA Mondol, M Jalaluddin, S Tabassum, MN Islam
July-September 2008, 26(3):282-283
DOI:10.4103/0255-0857.42059  PMID:18695338
  3,569 286 3
Isolation of Mycobacterium malmoense in the island of Crete, Greece
IS Kourbeti, IK Neonakis, Z Gitti, DA Spandidos
July-September 2008, 26(3):267-269
DOI:10.4103/0255-0857.42046  PMID:18695331
Mycobacterium malmoense was isolated from a broncho-alveolar lavage sample of a 73-year-old cancer (small cell lung carcinoma) patient in Crete, representing the first reported case of this pathogen in Greece. The isolate was considered to be a colonizer and the patient did not receive any antimycobacterial treatment while he received chemotherapy to which he responded favourably. No signs of pulmonary infection were noted during the course of his disease. This case provides evidence of the ubiquitous nature of this mycobacterial species, believed until recently to favour cooler climates. We, therefore, propose that the index of suspicion for this pathogen should be raised particularly in patients with underlying immunodeficiency, cancer and chronic lung disease, irrespective of the geographic location.
  3,357 163 1
Mixed Salmonella infection
D Debdas, S Joshi
July-September 2008, 26(3):287-287
DOI:10.4103/0255-0857.42073  PMID:18695342
  3,143 280 1
Study of HIV seroprevalence and sociodemographic patterns in antenatal cases and vertical transmission to neonates
M Mathur, S Taklikar, D Turbadkar
July-September 2008, 26(3):289-290
DOI:10.4103/0255-0857.42075  PMID:18695344
  2,415 235 -
Research snippets from the medical world
P Desikan
July-September 2008, 26(3):291-292
  2,255 191 -

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

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