Indian Journal of Medical Microbiology IAMM  | About us |  Subscription |  e-Alerts  | Feedback |  Reader Login  
  Print this page Email this page   Small font sizeDefault font sizeIncrease font size
 Home | Ahead of Print | Current Issue | Archives | Search | Instructions  
Users Online: 629 Official Publication of Indian Association of Medical Microbiologists 
  ~   Site Statistics 
  ~   Addresses 
  ~   Search 
  ~   My Preferences 
  ~   Online Submission 

 


Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
  Access statistics : Table of Contents
   2013| July-September  | Volume 31 | Issue 3  
    Online since July 25, 2013

 
 
  Archives   Previous Issue   Next Issue   Most popular articles   Most cited articles
 
Hide all abstracts  Show selected abstracts  Export selected to
  Viewed PDF Cited
CASE REPORTS
Elizabethkingia meningoseptica : An emerging pathogen causing meningitis in a hospitalized adult trauma patient
V Tak, P Mathur, P Varghese, MC Misra
July-September 2013, 31(3):293-295
DOI:10.4103/0255-0857.115653  PMID:23883720
A 23-year-old male patient who was a follow-up case of neurosurgery presented to our emergency department with a history of high-grade fever and clinical features of meningitis for 1 week. The cerebrospinal fluid (CSF) was sent to our laboratory for culture. The culture demonstrated growth of 1-2 mm in diameter light yellow coloured colonies of Gram-negative bacilli on chocolate and blood agar. There was no growth on MacConkey agar. The bacterium was multidrug resistant. Based upon the growth characteristics, bio-chemical reactions, drug susceptibility pattern and identification by Vitek 2 system the isolate was identified as Elizabethkingia meningoseptica. Patient was treated with injection piperacillin-tazobactam, injection vancomycin and cotrimoxazole tablets for 21 days along with intrathecal injection of tigecycline and finally, patient improved clinically and the CSF cultures became sterile. The presence in hospital environment along with multidrug resistance makes E. meningoseptica a successful emerging nosocomial pathogen.
  12,997 282 -
ORIGINAL ARTICLES
Prevalence of hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus and hepatitis E virus as causes of acute viral hepatitis in North India: A hospital based study
P Jain, S Prakash, S Gupta, KP Singh, S Shrivastava, DD Singh, J Singh, A Jain
July-September 2013, 31(3):261-265
DOI:10.4103/0255-0857.115631  PMID:23883712
Context: Acute viral hepatitis (AVH) is a major public health problem and is an important cause of morbidity and mortality. Aim: The aim of the present study is to determine the prevalence of hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV) and hepatitis E virus (HEV) as causes of AVH in a tertiary care hospital of North India. Settings and Design: Blood samples and clinical information was collected from cases of AVH referred to the Grade I viral diagnostic laboratory over a 1-year period. Subjects and Methods: Samples were tested for hepatitis B surface antigen, anti-HCV total antibodies, anti-HAV immunoglobulin M (IgM) and anti-HEV IgM by the enzyme-linked immunosorbent assay. PCR for nucleic acid detection of HBV and HCV was also carried out. Those positive for HBV infection were tested for anti-HDV antibodies. Statistical Analysis Used: Fisher's exact test was used and a P < 0.05 was considered to be statistically significant. Results: Of the 267 viral hepatitis cases, 62 (23.22%) patients presented as acute hepatic failure. HAV (26.96%) was identified as the most common cause of acute hepatitis followed by HEV (17.97%), HBV (16.10%) and HCV (11.98%). Co-infections with more than one virus were present in 34 cases; HAV-HEV co-infection being the most common. HEV was the most important cause of acute hepatic failure followed by co-infection with HAV and HEV. An indication towards epidemiological shift of HAV infection from children to adults with a rise in HAV prevalence was seen. Conclusions: To the best of our knowledge, this is the first report indicating epidemiological shift of HAV in Uttar Pradesh.
  11,810 813 1
REVIEW ARTICLES
Universal screening versus universal precautions in the context of preoperative screening for HIV, HBV, HCV in India
R Ahmed, S Bhattacharya
July-September 2013, 31(3):219-225
DOI:10.4103/0255-0857.115623  PMID:23883705
In the Indian context, there is a convention of doing pre-operative screening for HIV, hepatitis B virus and hepatitis C viruses for all patients as a routine pre-intervention investigation. This approach is justified in some instances in the best interest of the patient. However, as routine screening is not the standard care internationally and as there is a significant divergence of views about the merits and demerits of this practice, this issue needs to be debated in a rational manner with an evidence-based approach. The present article is authored by a surgeon and a microbiologist from a new cancer care centre in eastern India, who has attempted to address this contentious issue. The various available options have been explored, and advantages and disadvantages of the different approach have been discussed. An algorithm for infection prevention and control has been presented so that surgeons and medical microbiologists could manage infection control challenges satisfactorily.
  9,603 750 1
CASE REPORTS
Streptococcus pasteurianus septicemia
D Alex, DF Garvin, SM Peters
July-September 2013, 31(3):310-312
DOI:10.4103/0255-0857.115668  PMID:23883726
Streptococcus pasteurianus is part of the normal flora of the intestine. It has also been isolated from various infection sites. However, to date it has not been reported as a cause of fulminant septicemia and death. We report the post-mortem findings in a splenectomized hemophiliac patient with cirrhosis and concurrent human immunodeficiency virus (HIV), hepatitis B and hepatitis C infections.
  6,768 123 -
Ochrobactrum anthropi : An unusual pathogen: Are we missing them?
SS Mudshingkar, AC Choure, MS Palewar, VB Dohe, AS Kagal
July-September 2013, 31(3):306-308
DOI:10.4103/0255-0857.115664  PMID:23883724
With increasing incidence of immunocompromised patients, many unusual organisms are emerging as pathogens in these patients. Ochrobactrum anthropi is an emerging opportunistic pathogen in immunocompromised patients. Here, we report two cases of neonates who presented with septicemia due to O. anthropi. Both were preterm and low birth weight babies admitted in the Neonatal Intensive Care Unit of our Hospital. One baby manifested with respiratory distress and eventually died. The second baby responded well to treatment and was discharged. The clinical presentation of infections along with microbiological characteristics and clinical significance of the organism are described.
  6,276 151 -
BRIEF COMMUNICATIONS
Assessment of reactivity of three treponemal tests in non-treponemal non-reactive cases from sexually transmitted diseases clinic, antenatal clinic, integrated counselling and testing centre, other different outdoor patient departments/indoor patients of a tertiary care centre and peripheral health clinic attendees
M Bala, V Singh, S Muralidhar, V Ramesh
July-September 2013, 31(3):275-279
DOI:10.4103/0255-0857.115638  PMID:23883715
In India, many state reference centres for sexually transmitted infections perform only a single screening assay for syphilis diagnosis. In this study, Treponema pallidum haemagglutination (TPHA) was performed on 1115 Venereal Disease Research Laboratory (VDRL)/rapid plasma regain (RPR) non-reactive and 107 reactive sera out of 10,489 tested by VDRL/RPR according to the National AIDS Control Organisation syphilis testing protocol. A total of 47 Specimens reactive in TPHA and non-reactive with VDRL test were subjected to fluorescent treponemal antibody absorption and enzyme-immunoassay. Seroprevalence considering both VDRL and TPHA positivity was highest (4.4%) in sexually transmitted diseases clinic attendees than in other subject groups. Positivity by two treponemal tests in 24 (2.2%) cases non-reactive by VDRL/RPR was representative of the fully treated patients or latent or late syphilis cases. The findings highlight that a suitable treponemal confirmatory test should be performed in all the diagnostic laboratories.
  6,085 216 1
CASE REPORTS
Microsporum gypseum dermatophytosis in a patient of acquired immunodeficiency syndrome: A rare case report
S Bhagra, SA Ganju, A Sood, RC Guleria, AK Kanga
July-September 2013, 31(3):295-298
DOI:10.4103/0255-0857.115656  PMID:23883721
Microsporum gypseum, a geophillic dermatophyte is rarely isolated from patients with acquired immunodeficiency syndrome. We report tinea corporis due to Microsporum gypseum, an uncommon aetiological agent, in a patient with acquired immunodeficiency syndrome from our region. The clinical presentation resembled psoriasis characterised by atypical, scaly and hyperkeratotic lesions.
  6,063 163 1
EDITORIAL
Accreditation of Microbiology Laboratories: A Perspective
A Kapil
July-September 2013, 31(3):217-218
DOI:10.4103/0255-0857.115622  PMID:23883704
  5,105 791 -
ORIGINAL ARTICLES
Study of the distribution of Malassezia species in patients with pityriasis versicolor and healthy individuals in Tertiary Care Hospital, Punjab
M Kaur, T Narang, M Bala, S Gupte, P Aggarwal, A Manhas
July-September 2013, 31(3):270-274
DOI:10.4103/0255-0857.115636  PMID:23883714
Purpose: Pityriasis versicolor (PV) is a chronic superficial fungal disease caused by Malassezia species. Our aim was to identify Malassezia species from PV patients and healthy individuals in Punjab. Materials and Methods: Modified Dixon agar was used as isolation culture medium. Identification was based on morphological observation and biochemical evaluation. The biochemical evaluation consisted of culture onto Sabouraud dextrose agar, catalase reaction, Tween assimilation, Cremophor EL assimilation, splitting of esculin and growth at 38 0 C. Results: Out of 58 microscopically diagnosed cases of PV, growth was obtained from 54 (93.10%) cases. The most frequently isolated species were M. globosa, M. sympodialis and M. furfur which made up 51.79%, 31.42% and 18.51% of the isolated etiological agents respectively. However, the major isolate from the back of healthy individuals was M. sympodialis (47.61%), followed by M.obtusa (19.04%), M. globosa (14.20%), M. furfur (9.52%), M. pachydermatis (4.76%) and M. slooffiae (4.76%). Conclusions: M. globosa in its mycelial phase was the main etiological agent, but as normal flora from the back of healthy subjects, it was found in significantly less number (P = 0.01), suggesting that the higher pathogenicity of M. globosa in terms of enzymatic endowment, might be the cause of its predominance in PV lesions.
  4,322 358 1
Multiple carbapenem hydrolyzing genes in clinical isolates of Acinetobacter baumannii
DK Niranjan, NP Singh, V Manchanda, S Rai, IR Kaur
July-September 2013, 31(3):237-241
DOI:10.4103/0255-0857.115626  PMID:23883708
Purpose: Carbapenem resistance in Acinetobacter baumannii has become highly rampant, which has been ascribed to the presence of multiple carbapenemases. The objective of the present study was to prospectively investigate the presence of multiple carbapenemase encoding genes in clinical isolates of A. baumannii. Materials and Methods: A total of 30 imipenem resistant, consecutive non-repeat clinical isolates A. baumannii from a Tertiary Care Centre of Delhi were subjected to antimicrobial susceptibility testing (AST), screening for carbapenemase production by modified Hodge test (MHT) and determination of minimum inhibitory concentration for imipenem by E-Test® . These were subjected to Real time PCR for blaIMP-1 and 2 , blaVIM-1 and 2 , blaOXA23, 24, 51 and 58 using SYBR green-I. These were grouped together on the basis of their genotype as each isolate harboured multiple carbapenemases and correlated with their AST profile. Detection of the novel carbapenemase blaNDM-1 was performed by real time PCR using TaqMan probes on 14 isolates. Results: Colistin appeared to be the most effective drug in vitro, followed by tetracycline and beta lactam/beta lactamase inhibitor combinations. All, but one isolate were positive for the MHT. All 30 isolates were positive for blaOXA-51 like gene as well as blaIMP-1 and blaVIM-1 genes. blaOXA 24 and 58 were not detected in any of the isolates. blaIMP-2 , blaVIM-2 , blaOXA-23 were present in 15, 6 and 14 isolates respectively. Grouping based on the genotypic profile did not correlate with susceptibility pattern. Nine among the 14 isolates also harboured the novel blaNDM-1 gene. Conclusions: This is the first study from North India, which comprehensively detected the presence of multiple carbapenemases as well the blaNDM-1 gene. The presence of the novel gene blaNDM-1 indicated ability of A. baumannii to acquire new carbapenemase genes despite the existence of multiple carbapenemase genes. The present study confirmed the presence of multiple genetic mechanisms for carbapenemases production among the clinical isolates of A. baumannii in north India.
  3,644 417 1
CORRESPONDENCE
Prevalence of hepatitis C virus infection among blood donors of Kumaon region of Uttarakhand
V Rawat, U Bhatt, M Singhai, A Kumar, YPS Malik
July-September 2013, 31(3):313-314
DOI:10.4103/0255-0857.115669  PMID:23883727
  3,798 185 -
BRIEF COMMUNICATIONS
Assessing effect of climate on the incidence of dengue in Tamil Nadu
S Chandy, K Ramanathan, A Manoharan, D Mathai, K Baruah
July-September 2013, 31(3):283-286
DOI:10.4103/0255-0857.115640  PMID:23883717
Incidence of dengue is reported to be influenced by climatic factors. The objective of this study is to assess the association of local climate with dengue incidence, in two geographically distinct districts in Tamil Nadu. The study uses climate data, rainfall and mean maximum and minimum temperature to assess its association if any, with dengue incidence in two districts of Tamil Nadu, South India. According to this study while precipitation levels have an effect on dengue incidence in Tamil Nadu, non-climatic factors such as presence of breeding sites, vector control and surveillance are important issues that need to be addressed.
  3,547 239 1
CASE REPORTS
Zero CD4 count: A case of discordant CD4 response in a patient with well suppressed viral load
K Raja, C Chandrasekar, OR Krishnarajasekhar, G Manoharan
July-September 2013, 31(3):298-302
DOI:10.4103/0255-0857.115658  PMID:23883722
Human immunodeficiency virus (HIV) positive patients continue to have raise in CD4 cell for several years after initiation of anti-retroviral therapy (ART). The discordant response of static or fall in CD4 cells in presence of well-suppressed viral load is an unusual finding. In this communication, we present a case report of an HIV patient in whom the repeated CD4 enumerations consistently showed zero/nil CD4 counts before and after the start of ART in spite of maximum viral suppression.
  3,668 117 1
ORIGINAL ARTICLES
Incidence of blaNDM-1 gene in Escherichia coli isolates at a tertiary care referral hospital in Northeast India
A Bora, GU Ahmed, NK Hazarika, KN Prasad, SK Shukla, V Randhawa, JB Sarma
July-September 2013, 31(3):250-256
DOI:10.4103/0255-0857.115628  PMID:23883710
Purpose: Increasing reports on New Delhi metallo-β-lactamase-1 (NDM-1) producing Escherichia coli constitute a serious threat to global health since it is found to be highly resistant to most of the currently available antibiotics including carbapenems. This study has been performed to find out the incidence blaNDM-1 in E. coli isolates recovered from the various clinical samples at a tertiary care referral hospital in Northeast India. Materials and Methods: A total of 270 non-duplicated E. coli isolates were recovered from the various clinical samples at a tertiary care referral hospital in Northeast India. All isolates with reduced susceptibility to meropenem or ertapenem (diameter of zones of inhibition, ≤21 mm) were further phenotypically confirmed for carbapenemase production by modified Hodge test. All screened isolates were also subjected to the polymerase chain reaction detection of blaNDM-1 gene and additional bla genes coding for transmission electron microscopy, SHV, CTX-M, and AmpC. Results: Out of 270 E. coli isolates, 14 were screened for carbapenemase production on the basis of their reduced susceptibility to meropenem or ertapenem. All screened isolates were found to be positive for blaNDM-1 . Each of the blaNDM-1 possessing isolate was also positive for two or more additional bla genes, such as blaTEM , blaCTX-M and blaAmpC . Phylogenetic analysis showed very less variation in blaNDM-1 gene with respect to blaNDM-1 possessing E. coli isolates from other parts of India and abroad. Conclusions: Our findings highlight the incidence of blaNDM-1 in E. coli isolates with a reduced susceptibility to meropenem or ertapenem.
  3,182 369 1
Use of GenoType® MTBDRplus assay to assess drug resistance and mutation patterns of multidrug-resistant tuberculosis isolates in northern India
AK Maurya, AK Singh, S Kant, J Umrao, M Kumar, RAS Kushwaha, VL Nag, TN Dhole
July-September 2013, 31(3):230-236
DOI:10.4103/0255-0857.115625  PMID:23883707
Purpose: The emergence and spread of multidrug-resistant tuberculosis (MDR-TB) is a major public health problem. The diagnosis of MDR-TB is of paramount importance in establishing appropriate clinical management and infection control measures. The aim of this study was to evaluate drug resistance and mutational patterns in clinical isolates MDR-TB by GenoType® MTBDRplus assay. Material and Methods: A total of 350 non-repeated sputum specimens were collected from highly suspected drug-resistant pulmonary tuberculosis (PTB) cases; which were processed by microscopy, culture, differentiation and first line drug susceptibility testing (DST) using BacT/ALERT 3D system. Results: Among a total of 125 mycobacterium tuberculosis complex (MTBC) strains, readable results were obtained from 120 (96%) strains by GenoType® MTBDRplus assay. Only 45 MDR-TB isolates were analysed for the performance, frequency and mutational patterns by GenoType® MTBDRplus assay. The sensitivity of the GenoType® MDRTBplus assay for detecting individual resistance to rifampicin (RIF), isoniazid (INH) and multidrug resistance was found to be 95.8%, 96.3% and 97.7%, respectively. Mutation in codon S531L of the rpoB gene and codon S315T1 of katG genes were dominated in MDR-TB strains, respectively (P < 0.05). Conclusions: The GenoType® MTBDRplus assay is highly sensitive with short turnaround times and a rapid test for the detection of the most common mutations conferring resistance in MDR-TB strains that can readily be included in a routine laboratory workflow.
  2,952 362 1
Clonal diversity of New Delhi metallobetalactamase-1 producing Enterobacteriaceae in a tertiary care centre
M Shanthi, U Sekar, M Sowmiya, J Malathi, A Kamalanathan, B Sekar, HN Madhavan
July-September 2013, 31(3):237-241
DOI:10.4103/0255-0857.115627  PMID:23883709
Purpose: New Delhi metallobetalactamase-1 (NDM-1) production is a major mechanism of resistance to carbapenems among the Enterobacteriaceae and is a cause for concern in the field of microbial drug resistance. This study was performed to detect NDM-1 in Enterobacteriaceae and to determine the clonal relatedness of NDM-1 producing Escherichia coli and Klebsiella pneumoniae isolated from patients admitted in a tertiary care centre. Materials and Methods: A total of 111 clinically significant Enterobacteriaceae isolates, resistant to cephalosporin subclass III were screened for carbapenemase production by the modified Hodge test. Minimum inhibitory concentration to imipenem and meropenem was determined and interpreted according to Clinical Laboratory Standards Institute 2011 criteria. Presence of bla NDM-1 was detected by polymerase chain reaction. To ascertain clonal relatedness, random amplification of polymorphic deoxyribonucleic acid (RAPD) was carried out for representative NDM-1 producers. Results : bla NDM-1 was detected in 64 study isolates, of which 27 were susceptible to carbapenems. RAPD revealed a high degree of clonal diversity among NDM-1 producers except for a small clustering of isolates in the neonatal intensive care unit. Conclusion: There is extensive clonal diversity among the NDM-1 producing E. coli and K. pneumoniae. Hence, antibiotic selection pressure rather than horizontal transfer is probably an important operating factor for the emergence of NDM-1. This calls for increased vigilance, continuous surveillance and strict enforcement of antibiotic policy with restricted use of inducer drugs.
  2,774 447 -
Fungal rhinosinusitis: A prospective study in a University hospital of Uttar Pradesh
S Prateek, G Banerjee, P Gupta, M Singh, MM Goel, V Verma
July-September 2013, 31(3):266-269
DOI:10.4103/0255-0857.115634  PMID:23883713
Background: To assess the purpose of fungal rhinosinusitis in a University hospital and to correlate histopathological findings with culture results for accurate clinical classification of the disease. Materials and Methods: One-hundred suspected patients were included in the study. Data was collected in a brief predetermined format. Samples like nasal lavages, sinus secretions, and tissue specimens were processed and examined by microbiology culture using recommended techniques. Slide culture was done to observe the microscopic morphology. Histopathological examination was done by H and E stain and PAS stain for classification. Results: Out of 100 cases of rhinosinusitis, 21 cases were culture-positive for fungal rhinosinusitis. On the basis of histopathological findings, 14 cases (66.67%) were found to be of non-invasive fungal rhinosinusitis. Aspergillus flavus was the most common fungal isolate. Conclusion: Mycological profile of rhinosinusitis in Lucknow was thus evaluated. Histopathological and microbiological findings reported 21 cases of fungal rhinosinusitis among 100 suspected cases of rhinosinusitis.
  2,646 352 1
BRIEF COMMUNICATIONS
Antimicrobial resistance pattern and in vivo activity of azithromycin in Salmonella isolates
A Garg, S Verma, A Kanga, D Singh, B Singh
July-September 2013, 31(3):287-289
DOI:10.4103/0255-0857.115641  PMID:23883718
We evaluated antimicrobial susceptibility pattern of 42 Salmonella isolates from February 2012 through January 2013. We also determined the minimum inhibitory concentrations (MICs) of azithromycin against Salmonella isolates and compared them with corresponding disc diffusion sizes. Entire 42 isolates were sensitive to chloramphenicol, 41 (97.6%) were sensitive to cotrimoxazole and amoxicillin each. MICs for azithromycin ranged from 2 μg/ml to 24 μg/ml, corresponding zone diameters ranged from 15 mm to 33 mm and the two were significantly correlated (P = 0.001). Our results indicate that whereas, azithromycin is a potential therapeutic option, the sensitivity to the first line drugs and absence of multidrug resistance reinforce the concept of antimicrobial recycling.
  2,612 289 -
Mind the mind: Results of a hand-hygiene research in a state-of-the-art cancer hospital
R van Dalen, K Gombert, S Bhattacharya, SS Datta
July-September 2013, 31(3):280-282
DOI:10.4103/0255-0857.115639  PMID:23883716
Poor hand-hygiene (HH) is the primary cause of health-care related infections, yet compliance has proven to be challenging. This multi-method study into HH in a state-of-the-art cancer hospital demonstrates that the presence of resources and prioritisation of HH alone is not sufficient for HH compliance. A large gap was found between perceived (87%) and actual (52%) HH compliance and knowledge. Similarly, although 82% of the respondents knew proper HH moments, they did not act on it. These gaps between perception and reality suggest that resources, knowledge and training might not be sufficient for improving HH: Psychological barriers need to be addressed too.
  2,501 194 1
CASE REPORTS
Alternaria alternata in a case of mass in the lung
RP Shashikala, A Saikumar, K Ramesh, V Aparana
July-September 2013, 31(3):308-310
DOI:10.4103/0255-0857.115667  PMID:23883725
A 50-year-old woman, an agriculture worker with diabetes and asthma presented to us with complaints of fever with chills, cough with scanty, mucopurulent sputum and dull aching chest pain in right mammary area radiating to axilla. Chest X-ray and computed tomography scan revealed mass in the right lung. Ultrasound guided fine-needle aspiration cytology was done and the greenish fluid on direct wet mount and inoculation on Sabouraud's dextrose agar isolated Alternaria species. Serum specimen was evaluated for immunoglobulin E specific titres for Alternaria species which was high. Patient was treated with fluconazole for 6 weeks after which the symptoms disappeared and chest X-ray was normal.
  2,571 89 1
Rhizomucor variabilis : A rare causative agent of primary cutaneous zygomycosis
AB Patil, K Chandramohan, MR Shivaprakash, SD Nadgir, SA Lakshminarayana
July-September 2013, 31(3):302-305
DOI:10.4103/0255-0857.115662  PMID:23883723
Rhizomucor variabilis is a rare cause of human infections. We report a case of primary cutaneous zygomycosis in an immunocompetent host. Although microscopy reveals the fungal aetiology, the need for species identification is highlighted to better understand the species and establish an epidemiological pattern as it is reported from restricted geographical locations.
  2,361 103 1
ORIGINAL ARTICLES
Interleukin-5, interleukin-6, interleukin-8 and tumour necrosis factor-alpha levels obtained within 24-h of admission do not predict high-risk infection in children with febrile neutropenia
R Aggarwal, D Bansal, F Bansal, N Nanda, P Ray, A Trehan, RK Marwaha
July-September 2013, 31(3):226-229
DOI:10.4103/0255-0857.115624  PMID:23883706
Purpose: Biomarkers that can predict the severity of febrile neutropenia (FN) are potential tools for clinical practice. Objective: The objective of this study is to evaluate the reliability of plasma interleukin (IL) levels as indicators of high-risk FN. Materials and Methods: Children with haematological malignancies and FN were enrolled prospectively. A blood sample was obtained within 24-h of admission for estimation of IL-5, IL-6, IL-8 and tumour necrosis factor-alpha (TNF-α) level by the enzyme-linked immunosorbent assay. Patients were stratified into three groups. Group I (low-risk): No focus of infection; Group II: Clinical/radiological focus of infection; Group III: Microbiologically proven infection or FN related mortality. Groups II and III were analysed as high-risk. The cytokines were assessed at three different cut-off levels. Results: A total of 52 episodes of FN in 48 patients were evaluated. The mean age was 6 years (range: 2-13). Primary diagnosis included acute lymphoblastic leukaemia (82%), non-Hodgkin's lymphoma (13%) and acute myeloid leukaemia (5%). Absolute neutrophil count was < 200 cells/μl in half and 200-500 in 23%. Majority were categorised as Group I (69%), followed by Group II (16%) and III (15%). The range of IL-5 was too narrow and similar in the two risk-groups to be of any relevance. The best sensitivity of TNF-α and IL-6 for high-risk group was 78% and 70%, respectively. The highest specificity observed was 35%. The negative predictive value of IL-6, IL-8 and TNF-α exceeded 80%. Conclusion: IL-5, IL-6, IL-8 and TNF-α failed as predictors of clinically localised or microbiologically documented infection in children with chemotherapy induced FN. However, IL-6, IL-8 and TNF-α could be useful in excluding the possibility of high-risk infection.
  2,168 182 -
Co-existence of Pseudomonas-derived cephalosporinase among plasmid encoded CMY-2 harbouring isolates of Pseudomonas aeruginosa in north India
S Upadhyay, S Mishra, MR Sen, T Banerjee, A Bhattacharjee
July-September 2013, 31(3):257-260
DOI:10.4103/0255-0857.115629  PMID:23883711
Context: In Pseudomonas aeruginosa, AmpC β-lactamases are often responsible for high-level resistance to β-lactam antibiotics. The co-production of plasmid-mediated AmpC along with chromosomal Pseudomonas-derived cephalosporinases thus remain a serious clinical concern owing to high resistance spectrum towards antibiotics. Aim: The present study was performed to investigate the co-existence of both chromosomally-encoded and plasmid-mediated AmpC β-lactamase among clinical isolates of P. aeruginosa. Setting and Design: It is a cross-sectional study carried out in the Department of Microbiology in a tertiary referral hospital of northern India. Methods and Methods: A total of 329 consecutive, non-duplicate clinical isolates of P. aeruginosa, were selected for the detection of AmpC β-lactamases and confirmed for AmpC production by modified three dimensional (M3D) test. Ceftazidime -imipenem antagonism test was used to detect inducible AmpC producers. Molecular characterisation of chromosomally-encoded blaPDC and plasmid-mediated AmpC gene was studied by performing polymerase chain reaction (PCR). Result: A total of 214 (65%) isolates were confirmed for AmpC production by M3D test. On performing multiplex PCR, 27 isolates were detected posessing blaCMY type of plasmid-mediated AmpC gene. While 48 isolates were found to harbour chromosomally-encoded blaPDC gene co-production of both chromosomal and plasmid-encoded AmpC was reported in eleven isolates. Conclusions: Although these chromosomally-encoded cephalosporinases might spread more slowly than mobilised AmpC, but it is likely that in the present scenario of intense antibiotic pressure, this will become an increasing problem and may further limit our antibiotic choices.
  1,970 201 -
CORRESPONDENCE
Seroprevalence of human immunodeficiency virus type 2 infection from a tertiary care hospital in Pune, Maharashtra: A 2 year study
VS Tadokar, MS Kavathekar
July-September 2013, 31(3):314-315
DOI:10.4103/0255-0857.115670  PMID:23883728
  1,969 151 -
CASE REPORTS
Characterisation of mumps virus genotype C among patients with mumps in India
M Jeevan, S Sambantham, M Thangam
July-September 2013, 31(3):290-292
DOI:10.4103/0255-0857.115644  PMID:23883719
Measles, mumps and rubella (MMR) vaccine failure had been reported globally and here, we report that it occurs in India now. MMR vaccinated people have developed acute mumps accompanied by anti-mumps immunoglobulin M. Genotypic characterisation revealed that the circulating mumps strain was genotype C, which is distinct from the vaccine strain of genotype N (L-Zagreb). This is the first report in India to suggest that genotype C is responsible for the present mumps infection. Thus, the present MMR vaccine must be revamped and optimised for its efficacy to prevent any future mumps epidemics.
  1,958 138 1
CORRESPONDENCE
Hand-held hazards by health-care workers
P Datta, N Bansal, J Chander
July-September 2013, 31(3):320-321
DOI:10.4103/0255-0857.115675  PMID:23883733
  1,764 167 -
NDM-1 producers as causative agents of nosocomial urinary tract infections
T Menon, V Naveen Kumar, M Sekar, A Princy
July-September 2013, 31(3):319-320
DOI:10.4103/0255-0857.115674  PMID:23883732
  1,698 203 -
What should be the criteria for application of modified Hodge test for carbapenemases in Klebsiella pneumoniae?
C Chande, P Veer, A Chivate, SG Joshi, A Chowdhary
July-September 2013, 31(3):318-319
DOI:10.4103/0255-0857.115673  PMID:23883731
  1,479 238 -
Tuberculous cholecystitis
B Swain, S Otta, SSG Mohapatra
July-September 2013, 31(3):317-317
DOI:10.4103/0255-0857.115672  PMID:23883730
  1,257 80 -
RESEARCH SNIPPET
Research Snippets
P Desikan
July-September 2013, 31(3):322-324
DOI:10.4103/0255-0857.115676  
  1,050 96 -
CORRESPONDENCE
Clinico-epidemiological profile of human immunodeficiency virus infection over a period of 3 years in a north Indian tertiary care hospital
C Jagdish, G Varsha, K Manpreet, S Nidhi
July-September 2013, 31(3):316-316
DOI:10.4103/0255-0857.115671  PMID:23883729
  933 117 -

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

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