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   2011| April-June  | Volume 29 | Issue 2  
    Online since June 2, 2011

 
 
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BRIEF COMMUNICATIONS
Yeast identification in routine clinical microbiology laboratory and its clinical relevance
S Agarwal, V Manchanda, N Verma, P Bhalla
April-June 2011, 29(2):172-177
DOI:10.4103/0255-0857.81794  PMID:21654115
Rapid identification of yeast infections is helpful in prompt appropriate antifungal therapy. In the present study, the usefulness of chromogenic medium, slide culture technique and Vitek2 Compact (V2C) has been analysed. A total of 173 clinical isolates of yeast species were included in the study. An algorithm to identify such isolates in routine clinical microbiology laboratory was prepared and followed. Chromogenic medium was able to identify Candida albicans, C. tropicalis, C. krusei, C. parapsilosis and Trichosporon asahii. Chromogenic medium was also helpful in identifying "multi-species" yeast infections. The medium was unable to provide presumptive identification of C. pelliculosa, C. utilis, C. rugosa, C. glabrata and C. hemulonii. Vitek 2 compact (V2C) differentiated all pseudohypae non-producing yeast species. The algorithm followed was helpful in timely presumptive identification and final diagnosis of yeast infections, including multi-species yeast infections.
  32,442 945 1
REVIEW ARTICLE
Could the products of Indian medicinal plants be the next alternative for the treatment of infections?
B Nandagopal, S Sankar, M Ramamurthy, S Sathish, G Sridharan
April-June 2011, 29(2):93-101
DOI:10.4103/0255-0857.81775  PMID:21654101
Indian medicinal plants are now recognized to have great potential for preparing clinically useful drugs that could even be used by allopathic physicians. Traditionally, practitioners of Indian medicine have used plant products in powder, syrup or lotion forms, without identification, quantification and dose regulation, unlike their allopathic counterparts. The present review explores the immense potential of the demonstrated effect of Indian medicinal plants on microbes, viruses and parasites. In the present context, with the available talent in the country like pharmaceutical chemists, microbiologists, biotechnologists and interested allopathic physicians, significant national effort towards identification of an "active principle" of Indian medicinal plants to treat human and animal infections should be a priority.
  9,765 682 2
CASE REPORTS
Intestinal obstruction due to Basidiobolus ranarum: An unusual case
Angeline Neetha Radjou, NG Rajesh
April-June 2011, 29(2):186-188
DOI:10.4103/0255-0857.81790  PMID:21654119
A case of intestinal obstruction caused by extensive soft tissue fungal infection of the perineum due to Basidiobolus ranarum is presented here. There was excellent response to antifungal treatment. A literature search revealed the case report of intestinal obstruction due to intrinsic mucosal involvement by the fungus, but extensive soft tissue involvement of the perineum resulting in extraneous obstruction to the rectum, has not been reported so far.
  9,815 138 3
A rare case of disseminated cysticercosis: Case report and literature review
A Banu, N Veena
April-June 2011, 29(2):180-183
DOI:10.4103/0255-0857.81787  PMID:21654117
Cysticercosis is a common tropical disease. One of the uncommon manifestations of cysticercosis and a rare complication is its disseminated form. We report an immunocompetent patient with disseminated cysticercosis who had involvement of the brain, subcutaneous tissues, lungs and skeletal muscles and presented with arthritis. He was otherwise asymptomatic in spite of the extensive involvement of multiple organs. A planned approach to therapy is necessary to prevent complications.
  8,958 266 1
BRIEF COMMUNICATIONS
Correlation of TEM, SHV and CTX-M extended-spectrum beta lactamases among Enterobacteriaceae with their in vitro antimicrobial susceptibility
A Manoharan, K Premalatha, S Chatterjee, D Mathai, SARI Study Group
April-June 2011, 29(2):161-164
DOI:10.4103/0255-0857.81799  PMID:21654112
Purpose: The present study was carried out to characterize the ESBL types and evaluated their in vitro activity against a collection of Gram negative bacteria (GNB) from a multicentric Indian surveillance study. Material and Methods: During January 2005 to June 2006, six tertiary care centres in India forwarded 778 non-duplicate GNB to our reference laboratory. Three hundred GNB from this collection were selected based on clinical significance and were used in the present study. Tested isolates included Escherichia coli (167), Klebsiella spp. (122) and Enterobacter spp. (11). ESBL screening and confirmation was performed for all the isolates. Minimum inhibitory concentration of imipenem, meropenem, ertapenem, levofloxacin, amikacin, piperacillin/tazobactam and ceftriaxone was determined by the E-test method. Molecular typing of the ESBLs was performed by polymerase chain reaction among the 121 selected isolates. Results: The study showed excellent susceptibility among the strains to imipenem (100%), meropenem (100%) and ertapenem (98.7%); good susceptibility to amikacin (89.7%) and piperacillin/tazobactam (85.3%) was observed. TEM and CTX-M were predominantly found in E. coli (39.2%) while, among the Klebsiella spp., TEM, SHV and CTX-M occurred together in 42.6% of the isolates. Conclusion: More than one ESBL was produced by many strains, and this was correlated with increased resistance levels. Carbapenems continue to show good in vitro activity and ertapenem is a potential alternative to imipenem and meropenem. Continued antimicrobial resistance surveillance is warranted in light of these findings.
  8,000 741 4
CASE REPORTS
Fatal rabies despite post-exposure prophylaxis
DG Deshmukh, AS Damle, JK Bajaj, JB Bhakre, NS Patil
April-June 2011, 29(2):178-180
DOI:10.4103/0255-0857.81786  PMID:21654116
Only sporadic reports of failure of post-exposure prophylaxis for rabies exist in the published literature. We are reporting such a case in a 3-year-old boy. The child had Category III dog bite on his right thigh. He presented with progressive ascending paralysis, finally developing quadriplegia and respiratory paralysis. Typical hydrophobia and aerophobia were absent. He received four doses of antirabies cell culture vaccine. He did not receive antirabies immunoglobulin. The boy succumbed on the 23 rd day of the dog bite. Diagnosis of rabies was confirmed in the laboratory by demonstration of Negri bodies, direct fluorescent antibody test and reverse transcriptase-polymerase chain reaction either on impression smear of brain or a piece of brain taken during autopsy.
  8,195 242 5
BRIEF COMMUNICATIONS
Biotypes and virulence factors of Gardnerella vaginalis isolated from cases of bacterial vaginosis
J Udayalaxmi, GK Bhat, S Kotigadde
April-June 2011, 29(2):165-168
DOI:10.4103/0255-0857.81798  PMID:21654113
The present study was conducted to correlate the biotypes of Gardnerella vaginalis strains isolated from cases of bacterial vaginosis and their virulence factors. Thirty-two strains of G. vaginalis isolated from cases of bacterial vaginosis were biotyped. Adherence to vaginal epithelial cells, biofilm production, surface hydrophobicity, phospholipase C and protease activity were tested on these isolates. Biotype 1 was the most prevalent (8; 25%), followed by biotype 2 (7; 21.9%) and biotypes 5 and 8 (5; 15.6%). We did not find any statistical correlation between G. vaginalis biotypes and its virulence factors. Virulence factors expressed by G. vaginalis were not associated with a single biotype.
  5,748 231 2
ORIGINAL ARTICLES
Development of a new method for diagnosis of Group B Coxsackie genome by reverse transcription loop-mediated isothermal amplification
K Jaianand, N Saravanan, P Gunasekaran, AK Sheriff
April-June 2011, 29(2):110-117
DOI:10.4103/0255-0857.81780  PMID:21654103
Background: Coxsackie B viruses (genus, Enterovirus; family, Picornaviridae) can cause aseptic meningitis, encephalitis, pleurodynia, and fatal myocarditis, and are implicated in the pathogenesis of dilated cardiomyopathy. The differentiation of the group B Coxsackieviruses into their subtypes has potential clinical and epidemiological implications. Objective: In this study, we developed a one-step, single-tube genogroup-specific reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay for the detection of group B Coxsackie genomes targeting 5′ UTR region. Materials and Methods: The amplification can be obtained in less than 1 hour by incubating all the reagents in a single tube with reverse transcriptase and Bst DNA polymerase at 63°C. Detection of gene amplification could be accomplished by agarose gel electrophoresis and the monitoring of gene amplification can also be visualised with the naked eye by using SYBR green I fluorescent dye. Results: A total of 40 samples comprising 31 positive samples and 9 negative samples were used in this study for comparative evaluation. The results were compared with those from Real-Time Polymerase Chain Reaction (RT-PCR). None of the RT-PCR-positive samples were missed by RT-LAMP, thereby indicating a higher sensitivity of the RT-LAMP assay. Conclusion: Thus, due to easy operation without a requirement of sophisticated equipment and skilled personnel, the RT-LAMP assay reported here is extremely rapid, cost-effective, highly sensitive, and specific and has potential usefulness for rapid detection of non-polio enterovirus (NPEV) not only by well-equipped laboratories but also by peripheral diagnostic laboratories with limited financial resources in developing countries.
  5,698 205 -
Comparison of a conventional polymerase chain reaction with real-time polymerase chain reaction for the detection of neurotropic viruses in cerebrospinal fluid samples
M Ramamurthy, M Alexander, S Aaron, R Kannangai, V Ravi, G Sridharan, AM Abraham
April-June 2011, 29(2):102-109
DOI:10.4103/0255-0857.81777  PMID:21654102
Purpose : To compare a conventional polymerase chain reaction (PCR) and real-time PCR for the detection of neurotropic DNA viruses. Materials and Methods : A total of 147 cerebrospinal fluid (CSF) samples was collected from patients attending a tertiary care hospital in South India for a period from 2005 to 2008. All these samples were tested using a conventional multiplex/uniplex PCR and a real-time multiplex/uniplex PCR. This technique was used to detect a large number of herpes viruses responsible for central nervous system infections, including HSV-1, HSV-2, VZV, CMV and EBV and the polyoma virus JCV. Results : Overall, in the entire set of samples, the real-time PCR yielded 88 (59.9%) positives and conventional PCR had six (4.1%) positives. Conclusion : Our results suggest that the real-time PCR assay was more sensitive compared with the conventional PCR. The advantage of real-time PCR is that it can be performed much faster than conventional PCR. Real-time PCR is less time-consuming, less labour-intensive and also reduces the chance of contamination as there is no post-amplification procedure. In the entire study population, the major viruses detected using real-time PCR were EBV (34%), HSV-2 (10.8%) and VZV (6.8%).
  5,160 498 -
BRIEF COMMUNICATIONS
Central venous catheter-related blood stream infection rate in critical care units in a tertiary care, teaching hospital in Mumbai
K Chopdekar, C Chande, S Chavan, P Veer, V Wabale, K Vishwakarma, A Joshi
April-June 2011, 29(2):169-171
DOI:10.4103/0255-0857.81796  PMID:21654114
Blood stream infections related to central venous catheterization are one of the major device-associated infections reported. Patients admitted in critical care units requiring central venous catheterization and presenting with signs of septicemia during catheterization period were investigated for catheter-related blood stream infections (CRBSI). The CRBSI rate was 9.26 per 1000 catheter days in general with highest rate in neonatal intensive care unit (27.02/1000 days). Site of insertion of catheter and duration of catheterization did not show the influence on the CRBSI rate. Coagulase-negative Staphylococci were the predominant cause. Mortality of 33% was observed in patients with CRBSI. Since central venous catheters are increasingly being used in the critical care, regular surveillance for infection associated them are essential.
  4,534 588 2
ORIGINAL ARTICLES
Risk factors for acquiring Strongyloides stercoralis infection among patients attending a tertiary hospital in south India
P Chordia, S Christopher, OC Abraham, J Muliyil, G Kang, SSR Ajjampur
April-June 2011, 29(2):147-151
DOI:10.4103/0255-0857.81797  PMID:21654109
Purpose: Strongyloides stercoralis causes persistent and fatal disseminated infections in immunocompromised hosts. In this study, we aimed to determine the risk factors for acquiring strongyloidiasis and the associated morbidity in south India. Materials and Methods: The study was carried out in two parts. This included a 6-month chart review of cases with strongyloidiasis and randomly selected controls conducted to determine the association with immunocompromised states. Secondly, a cross-sectional study was conducted to investigate hyperinfection in human immunodeficiency virus (HIV)-infected adults where the stool and sputum samples were examined by microscopy for Strongyloides larvae. Results: In the chart review, 118 cases were compared with 240 controls. A higher proportion of patients on corticosteroids [8 (53.3%)] and with HIV infection [3 (60%)] had the risk of acquiring strongyloidiasis than not, although the difference was not statistically significant in this population. In the cross-sectional study, 14/239 HIV-positive individuals had Strongyloides larvae in the stool samples but none had Strongyloides detectable in their sputum samples. The CD4 cell counts were significantly lower in cases with Strongyloides compared with HIV-infected individuals with no parasites in their stool samples (P < 0.001). Conclusions: In this setting, strongyloidiasis was seen more often in patients on corticosteroid therapy and with HIV infection. In HIV, an association with lower CD4 counts indicates the need for inclusion of Strongyloides as an opportunistic parasite. Gram negative sepsis was an important complication of strongyloidiasis hyperinfection in both HIV and steroid therapy. Further prospective studies on the risk of developing complicated Strongyloides infection are required.
  4,564 427 1
CORRESPONDENCES
Chryseobacterium indologenes bacteraemia in a preterm baby
V Sudharani, Asiya , NK Saxena
April-June 2011, 29(2):196-198
DOI:10.4103/0255-0857.81783  PMID:21654125
  4,749 177 4
ORIGINAL ARTICLES
High frequency of integrons related to drug-resistance in clinical isolates of Acinetobacter baumannii
Z Chang-Tai, L Yang, H Zhong-Yi, Z Chang-Song, K Yin-Ze, L Yong-Ping, D Chun-Lei
April-June 2011, 29(2):118-123
DOI:10.4103/0255-0857.81784  PMID:21654104
Purpose: As an opportunistic pathogen, Acinetobacter baumannii causes various nosocomial infections. In recent years, the increasing cumulative infection outbreaks involving A. baumannii have appeared worldwide. In addition, a perplexing trouble for clinical treatment is a severe drug-resistance problem with A. baumannii. In this study, we investigated the drug-resistance rates and integrons' distribution in A. baumannii clinical strains in East China. Furthermore, we explored the relationship between integrons and drug resistance. Materials and Methods: Strains were identified using non-fermenting bacteria identification cards by Vitek-32 system. Disk-diffusion method (Kirby-Bauer) was used to judge antimicrobial sensitivity. Integrons and the gene cassettes of integrons were identified by PCR, restriction enzyme digestion and DNA sequencing. Results: Except imipenem and cefoperazone/sulbactam, the drug-resistance rates of the A. baumannii clinical isolates to other 15 kinds of antibacterials, all surpassed 30%. Of 96 A. baumannii clinical isolates, 66 strains carried class 1 integrons (no class 2 or 3 integrons were found). Overall, the drug-resistance rates in integrons-positive A. baumannii to 14 kinds of antibacterials were higher than those in integrons-negative A. baumannii. Gene sequencing showed that 9 of 12 integrons contained seven different gene cassettes (aacA4, catB3, dfrA1, blam-1, orfX, aadA1, and sat2). The cassette arrays aacA4-catB3-dfrA1 was found in five detected integrons. Conclusions: High resistances in A. baumannii clinical strains to most common antimicrobial agents have appeared in East China, which was closely related with high frequencies class 1 integrons. A. baumannii integrons cassettes carried multi-drug-resistant gene codes. We believe that integrons cassettes gene could be taken as a marker of prognosticating A. baumannii antimicrobial resistance, but only reveal partial drug resistance profiles.
  4,102 253 -
The presence of dsRNA virus in Trichomonas vaginalis isolates from symptomatic and asymptomatic Indian women and its correlation with in vitro metronidazole sensitivity
N Malla, P Kaul, R Sehgal, I Gupta
April-June 2011, 29(2):152-157
DOI:10.4103/0255-0857.81801  PMID:21654110
Purpose: Trichomonas vaginalis, a protozoan parasite, is the causative agent of human trichomoniasis, the most common non-viral sexually transmitted disease. The infection encompasses from a complete asymptomatic presentation to severe sequelae; yet, the virulence markers have been poorly understood. It is suggested that the presence of Trichomonas vaginalis virus (TVV) in T. vaginalis may have an impact on its virulence, and its relatedness to in vitro metronidazole resistance has been reported. The aim of the study was to assess the presence of TVV in fresh and Long -Term Cultivated ( LTC) maintained T. vaginalis isolates from symptomatic (S) and asymptomatic (AS) Indian women and its relatedness, if any, with symptomatology and in vitro drug sensitivity. Materials and Methods: One thousand women (537 S and 463 AS) were screened for the presence of T. vaginalis by wet smear and culture examination of vaginal swab and urine sample. Fresh and LTC (6 months-2 years) maintained 15 isolates each from 15 S and 15 AS women were subjected to agarose gel electrophoresis following total cellular RNA extraction to evaluate the presence of double stranded (ds) RNA viral infection. The susceptibility of isolates to metronidazole was determined in vitro. Results: On agarose gel electrophoresis, three bands (5.5, 2.5 and 1.5 kb) were observed in all the 30 fresh isolates from 15 S and 15 AS women and only in 7 LTC isolates from 3 S and 4 AS women. All the fresh isolates harbouring TVV were found to be sensitive to metronidazole in vitro irrespective of the symptomatology of subjects, and out of seven LTC isolates harbouring TVV, six were sensitive to metronidazole and one showed borderline resistance. Conclusions: The results suggest that the presence of TVV alone may not be a virulence marker and loss of TVV on LTC appears to be related to drug resistance. The T. vaginalis Indian isolates are sensitive to metronidazole.
  4,111 219 6
GUEST EDITORIAL
Antimicrobial resistance: No action today, no cure tomorrow
A Sharma
April-June 2011, 29(2):91-92
DOI:10.4103/0255-0857.81774  PMID:21654100
  3,528 608 1
ORIGINAL ARTICLES
An outbreak of CTX-M-15-producing Klebsiella pneumoniae isolates in an intensive care unit of a teaching hospital in Kuwait
N Al Sweih, MF Salama, W Jamal, G Al Hashem, VO Rotimi
April-June 2011, 29(2):130-135
DOI:10.4103/0255-0857.81791  PMID:21654106
Objective: This study reports an outbreak of Klebsiella pneumoniae infections in 14 patients during a 2-month period (August-September, 2008) in the intensive care unit (ICU) of a teaching hospital in Kuwait. Materials and Methods: The clinical sources were blood (9), urine (3) and respiratory secretions (2) identified by the automated VITEK-2 ID System. Susceptibility testing was performed by the E-test method. Extended-spectrum β-lactamase (ESBL) production was assessed using the ESBL E-test and confirmed by PCR. Carriage of bla genes was determined by PCR and sequence analysis. The transferability of resistance phenotypes was demonstrated by conjugation experiments and clonal relatedness was determined by PFGE. Results: The isolates were susceptible to imipenem, meropenem, and tigecycline and produced ESBL. All isolates yielded an amplicon of 499 bp with universal consensus primers (MA primers). DNA sequence analysis showed that they all harboured blaCTX-M-15 and blaTEM-1 genes. The environmental isolate obtained from a suction machine was also CTX-M-15/TEM-1 producer. The resistance phenotypes were transferrable to the Escherichia coli J53 r strain. PFGE, revealed two clones, A and B, related with a Dice coefficient of >94.1%. A mortality rate of 21.4% was recorded. Conclusion: The outbreak was contained by robust and aggressive infection control measures. This study highlights the first outbreak of CTX-M-15-producing K. pneumoniae associated with high mortality in an adult medical ICU in Kuwait.
  3,786 269 3
CASE REPORTS
Case of sparganosis: A diagnostic dilemma
S Duggal, RK Mahajan, N Duggal, C Hans
April-June 2011, 29(2):183-186
DOI:10.4103/0255-0857.81789  PMID:21654118
Sparganosis, also known as larval diphyllobothriasis, is a rare disease of humans as man is not a natural host in the life cycle of Spirometra spp. Diagnosis of the latter is difficult as it mimics other conditions that commonly cause subcutaneous or visceral fluid collection. Clinical diagnosis of this particular case was also erroneously labelled as tuberculosis but later labelled as a case of sparganosis. To the best of our knowledge, this is the first case from India where a sparganum-like parasite was isolated in drain fluid from the perinephric area.
  3,777 141 3
ORIGINAL ARTICLES
Comparison of enzyme immunoassays detecting Helicobacter pylori specific IgG in serum and saliva with endoscopic and biopsy findings in patients with dyspepsia
A El-Mekki, A Kumar, B Alknawy, O Al-Ammari, R Moosa, S Quli, M Ahmed
April-June 2011, 29(2):136-140
DOI:10.4103/0255-0857.81793  PMID:21654107
Purpose: To compare the performance of two indirect enzyme-linked immunosorbent assays (ELISA) detecting Helicobacter pylori (HP)-specific IgG antibodies in serum and saliva with endoscopic observations and histologic findings of biopsies from dyspeptic patients, in an area of high HP prevalence. Materials and Methods : Sera, saliva and antral biopsies were obtained from 55 dyspeptic patients. IgG antibodies against HP were assayed in sera and saliva utilizing two indirect ELISAs. Biopsies were processed according to standard procedures in order to detect histological changes and the presence or absence of Helicobacter pylori. Laboratory data thus obtained were compared and statistically analyzed. Results: Forty-two (76.36%) biopsies were positive for HP. The organisms were detected in 4 of 16 (25%) cases with normal endoscopic findings, in all 16 cases of gastritis and in 22 of the 23 (95.6%) cases of duodenal ulcers (DU). Serum and saliva HP-specific IgG antibodies were detected in 4 normal cases with positive biopsies, in 12 and 14 cases of gastritis, respectively, and in all 22 (100%) biopsy positive cases of DU. The sensitivities of the serum and saliva tests were 90.5% and 95%, respectively, while the specificities were 84.5% and 70%, respectively. Conclusion: Due to their high sensitivity and specificity in diagnosing HP-associated DU and gastritis, serum and saliva antibody testing seems to offer a valuable alternative to invasive procedures especially in areas of high HP prevalence such as ours; saliva antibody testing is simple and practical especially in children and in difficult patients who resent venipuncture.
  3,435 271 3
CASE REPORTS
A rare case of Histoplasma fungemia in an AIDS patient
VP Baradkar, U Tendolkar, S Baveja, S Kamath
April-June 2011, 29(2):188-191
DOI:10.4103/0255-0857.81792  PMID:21654120
Disseminated cases of histoplasmosis in acquired immune deficiency syndrome (AIDS) are rarely reported from India. Most of these cases report isolation of this fungus from the bone marrow, lymph node aspirate, spleenic aspirate, and biopsies. We report isolation of Histoplasma capsulatum from the blood of an AIDS patient. A 30-year-old male from Utter Pradesh was admitted with fever, loss of appetite, and nausea since two months. Few intracellular and extracellular budding cells were observed on bone marrow examination on the fifth day of admission. Diagnosis was confirmed by blood cultures taken on the 11th day of admission. Amphotericin B was started, but the patient's condition deteriorated and he died.
  3,078 171 -
CORRESPONDENCES
Hydatid cyst in the spleen: A rare presentation
DV Patanvadia, YA Kruwala, S Lakhani, V Date, J Lakhani
April-June 2011, 29(2):192-193
DOI:10.4103/0255-0857.81778  PMID:21654121
  2,845 130 1
ORIGINAL ARTICLES
Evaluation of the therapeutic use of antibiotics in Aegean Region hospitals of Turkey: A multicentric study
O Ozgenç, VE Genç, AA Ari, El Sibel, S Saçar, H Ozunlu, A Akgul, N Demirturk, CB Çetin, M Sungur, SA Coskuner, Meltem Avci, O Ergonul, Antibiotic Resistance Study Group of Turkish Association of Clinical Microbiology and Infectious Diseases
April-June 2011, 29(2):124-129
DOI:10.4103/0255-0857.81788  PMID:21654105
Purpose: The antibiotic restriction policy has been validated nationwide since February 2003 by the Ministry of Health because the excessive consumption of antimicrobials causes a high cost. The aim of this study was to evaluate the therapeutic use of antibiotics in Aegean Region hospitals and to assess the impact of this nationwide antibiotic restriction policy. This new policy is based on justification that the infectious disease (ID) physicians should be primarily responsible for the prescription of antimicrobials. Materials and Methods: Eight university and government hospitals were included in the study. The criteria of the Council for Appropriate and Rational Antibiotic Therapy (CARAT) were considered. Both patient-based and antibiotic-based analyses were performed. For the analysis of inappropriate use, logistic regression was modeled. Results: Therapeutic use was determined in 540 patients by a total of 29 ID physicians.In the study, 30.2% of the patients were given antimicrobials and empirically started antibiotics accounted for 79% cases of therapeutic antibiotic use, and 60% of those were inappropriate (P = 0.001). The appropriate use of ID level antibiotics (P = 0.000) were very compatible with other antimicrobial groups. Conclusion: The study shows that the Turkish government's new intervention policy on antimicrobial prescribing has been effective.
  2,813 148 2
Evaluation of small-subunit rRNA touchdown polymerase chain reaction for direct detection of Entamoeba histolytica in human pus samples from patients with amoebic liver abscess
P Singh, BR Mirdha, V Ahuja, S Singh
April-June 2011, 29(2):141-146
DOI:10.4103/0255-0857.81795  PMID:21654108
Purpose: The aim of the present study was to evaluate the use of touchdown polymerase chain reaction (TD-PCR) for the detection of Entamoeba histolytica in liver pus samples obtained from patients with a clinical diagnosis of amoebic liver abscess (ALA) using small-subunit rRNA (SSU rRNA) as the target gene. Materials and Methods: Microscopic examination in vitro culture and serological test for the detection of E. histolytica in 67 pus samples obtained from ALA patients was performed. Molecular studies were carried out by both conventional PCR and TD-PCR targeting the SSU rRNA gene using the same sets of primers and the results were compared. Results: TD-PCR detected the presence of E. histolytica in 86.5% of the liver pus samples within 2.5 h as compared with 82.08% by conventional PCR within 3.5-4 h. Conclusion: TD-PCR assay may serve as a relatively better detection method for E. histolytica over conventional PCR with respect to the turnaround time, increased sensitivity, specificity and yield.
  2,638 170 1
BRIEF COMMUNICATIONS
Multi locus sequence type comparison of invasive and commensal Haemophilus influenzae isolates from Delhi
KK Saikia, R Bewal, D Bansal, A Kapil, S Sood, NK Arora, BK Das
April-June 2011, 29(2):158-160
DOI:10.4103/0255-0857.81800  PMID:21654111
Haemophilus influenzae is a major public health concern in the developing world. The most virulent strain is H. influenzae Type b (Hib). Hib also constitutes a major portion of nasopharyngeal commensal flora in otherwise healthy individuals. Through dendogram based on composite gene sequences of seven multi locus sequence type genes, it was observed that invasive and commensal isolates made two completely separate clusters which are indicative of independent evolution of these two groups of H. influenzae in the Indian subcontinent.
  2,385 152 -
CORRESPONDENCES
A combined diagnostic approach to Rheumatoid arthritis using anti-cyclic citrullinated peptide antibodies and rheumatoid factor
S Oommen, B Appalaraju, S Sivadarshini, Jayashree
April-June 2011, 29(2):195-196
DOI:10.4103/0255-0857.81782  PMID:21654124
  2,298 190 1
VITEK 2 and PHOENIX fail to detect high-level gentamicin-resistant Enterococcus faecium isolates with aac-aph gene
U Arslan, I Tuncer, D Findik, B Bozdogan
April-June 2011, 29(2):198-199
DOI:10.4103/0255-0857.81785  PMID:21654126
  1,864 117 -
A pilot cross-sectional study to determine the utility of an oral HIV1/2 point of care test on sputum for screening TB/HIV co-infection in Central India
P Desikan, S De, NP Pai, N Panwalkar, M Verma, A Jain
April-June 2011, 29(2):194-195
DOI:10.4103/0255-0857.81781  PMID:21654123
  1,689 117 1
RESEARCH SNIPPETS
Snippets
P Desikan
April-June 2011, 29(2):200-201
  1,359 117 -
CORRESPONDENCES
H1N1: Are our critical units prepared?
IA Hamid, NM Kumar
April-June 2011, 29(2):193-194
DOI:10.4103/0255-0857.81779  PMID:21654122
  1,316 108 -

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