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  ~ Table of Contents - Current issue
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April-June 2020
Volume 38 | Issue 2
Page Nos. 137-236

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GUEST EDITORIAL  

Moving beyond clinical medicine: Revised mandate for public health microbiology p. 137
Rahul Narang, Pradeep Deshmukh, Banke Lal Sherwal
DOI:10.4103/ijmm.IJMM_20_302  PMID:32883924
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REVIEW ARTICLE: COVID-19 SERIES Top

Healthcare facilities in low- and middle-income countries affected by COVID-19: Time to upgrade basic infection control and prevention practices Highly accessed article p. 139
Archana Angrup, Rimjhim Kanaujia, Pallab Ray, Manisha Biswal
DOI:10.4103/ijmm.IJMM_20_125  PMID:32883925
COVID-19 as a pandemic has spanned across all continents. With the increasing numbers in cases worldwide, even the countries with the best of healthcare facilities are reeling under the burden of the disease. Therefore, in countries with limited access to resources and poor healthcare infrastructure, the low and middle-income countries (LMICs), limiting spread becomes even more challenging. Low- and middle-income countries (LMICs) are severely hit by any outbreak and pandemics and face the lack of infrastructure and problem of overcrowding. Health facilities are compromised and almost exhausted at the time of emergency. There is disruption of normal supply chain, and consumables are not in sufficient quantity. In the current situation, rationalized use of available supplies is important. This paper presents the perspective on the basis of current literature on gaps in various infection prevention and control (IPC) strategies that are being followed currently in LMICs and suggestions for bridging these gaps.
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ORIGINAL ARTICLE: COVID-19 SERIES Top

Gender and occupation predict Coronavirus Disease 2019 knowledge, attitude and practices of a cohort of a South Indian state population p. 144
Sridhar Amalakanti, Kesava Venkata Raman Arepalli, Ravi Kiran Koppolu
DOI:10.4103/ijmm.IJMM_20_263  PMID:32883926
Context: Coronavirus disease 2019 (CoViD 19) pandemic has induced the government to initiate strict control measures. Improvements to these measures and shortcomings could be gleaned with the understanding of the knowledge, attitude and practices (KAP) of the public. Aims: The aim of this study the CoViD 19 KAP of a south Indian state population. Settings and Design: This was a Cross-sectional observational study. Subjects and Methods: We conducted an online survey to elicit this information. Statistical Analysis Used: Mean, Standard deviation, Binomial and Multinomial logistic regression. Results: Of the 1837 subjects who answered the survey, 70% were youth (16–29 years), 54% were postgraduates and 47.8% were desk jobholders. The mean knowledge score was 9.92 ± 2.37/14 and 94.44% secured at least above-average score. The subjects had a positive (70%) attitude towards the CoViD 19 situation and 77% of subjects followed good preventive practices. However, we found that women, people with low education and nonmedical background were associated with poor knowledge and practices. The attitude was poor in subjects occupant in physical works. Conclusions: The health policy would better serve the purpose of the groups with poor scores are targeted.
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ORIGINAL ARTICLES Top

Diagnostic utility of serology and polymerase chain reaction for detection of Mycoplasma pneumoniae and Chlamydophila pneumoniae in paediatric community-acquired lower respiratory tract infections p. 152
Sanchit Kumar, Bineeta Kashyap, Surinder Kumar, Seema Kapoor
DOI:10.4103/ijmm.IJMM_20_145  PMID:32883927
Purpose: Mycoplasma pneumoniae (M. pneumoniae) and Chlamydophila pneumoniae (C. pneumoniae) play a significant role in children of all ages with lower respiratory tract infections (LRTIs). This study was conducted to detect M. pneumoniae and C. pneumoniae in children with community-acquired LRTIs employing serology, polymerase chain reaction (PCR) and nested PCR analysis. Material and Methods: This study included 75 children with acute LRTIs for detection of M. pneumoniae and C. pneumoniae. Blood was obtained for M. pneumoniae and C. pneumoniae antibodies and nasopharyngeal aspirates for M. pneumoniae PCR and C. pneumoniae nested PCR. Results: M. pneumoniae infection was positive in 9 (64.21%) children aged 2–6 months and in 5 (35.79%) aged 7 months–12 years, and this difference was statistically significant (P = 0.002). C. pneumoniae infection was comparable within the age group and statistically insignificant (P = 0.43). Clinical and radiological profiles of M. pneumoniae- and C. pneumoniae-positive and negative patients were numerically comparable. Serology and PCR together detected M. pneumoniae infection in 14 (18.6%) children. The sensitivity, specificity and positive and negative predictive values of serology were 77.78%, 92.42%, 58.33% and 96.83%, respectively. C. pneumoniae infection was positive in 11 (14.6%) children by serology and nested PCR with 50% sensitivity, 87.67% specificity, 10% positive predictive value and 98.46% negative predictive value. Conclusions: Our study confirms that M. pneumoniae and C. pneumoniae play a significant role in community-acquired LRTIs and a combination of serology and nested PCR is useful for its diagnosis.
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Investigation of antimicrobial resistance and virulence genes of Campylobacter isolates from patients in a tertiary hospital in Edirne, Turkey p. 157
Canan Eryildiz, Kiymet Tabakcioglu, Gulcan Kuyucuklu, Nermin Sakru
DOI:10.4103/ijmm.IJMM_20_78  PMID:32883928
Purpose: Campylobacter is one of the most common pathogens that cause food-borne infections worldwide. The aim of this study was to determine the antimicrobial resistance rates and the presence of multiple virulence genes in Campylobacter isolates obtained from humans. Materials and Methods: In this study, 71 Campylobacter isolates obtained from human faecal samples were used. Antimicrobial susceptibility tests were performed through the gradient strip method. The presence of virulence genes was investigated by monoplex and multiplex polymerase chain reaction. Results: The rate of resistance of the 66 Campylobacter jejuni isolates was 12.1% for erythromycin, 40.9% for tetracycline and 68.2% for ciprofloxacin. Only one of five Campylobacter coli isolates was resistant to these three antimicrobial agents. The flaB, pldA, cdtA, cadF, cdtC and ceuE genes were found in all 66 of the C. jejuni isolates. In the C. jejuni isolates, positivity rates of 92.4% for flaA, 96.7% for cdtB, 98.5% for ciaB, 90.9% for dnaJ and 96.7% for racR were observed. The flaA, flaB, ciaB, cdtA and cdtC genes were present in all C. coli isolates. Conclusions: It was detected that there is an increase in antimicrobial resistance of Campylobacter strains in our region, and most of the isolates harbour virulence genes.
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Genotypic and phenotypic characterisation of clinical isolates of methicillin-resistant Staphylococcus aureus in two different geographical locations of Iran p. 162
Shiva Ahmadishoar, Nadia Kazemi Pour, Javid Sadeghi, Mohammad Reza Nahaei, Babak Kheirkhah
DOI:10.4103/ijmm.IJMM_20_153  PMID:32883929
Background: Methicillin-resistant Staphylococcus aureus (MRSA) has become more prevalent all over the world and it is important to determine MRSA prevalence and typing in different regions. The present study was carried out to determine the prevalence and frequency of circulating molecular types of MRSA isolates as well as their antibiotics susceptibility in Tabriz and Kerman cities of Iran. Materials and Methods: A total of 230 S. aureus isolates were collected from Tabriz (n=125) and Kerman (n=105) during January to December 2018. MRSA isolates were identified by PCR amplification of nuc and mec A genes. Antibiotic susceptibility of MRSA isolates were determined by Kirby-Bauer disk diffusion method. Multiplex PCR was exploited to detect various types of SCCmec. Results: The MRSA prevalence was 51/125 (40.8%) in Tabriz and 60/105 (57.1%) in Kerman. Overall, 36/51 (70.58%) and 15/51 (29.41%) isolates and 37/60 (61.66%) and 23/60 (38.34%) isolates were isolated from inpatients and outpatients in Tabriz and Kerman, respectively. Almost all of the isolates were resistant to penicillin and all of them were sensitive to linezolid. Thirty five (68.2%) and 34(56.6%) of MRSA isolates in Tabriz and Kerman were determined as MDR, respectively. SCCmec typing showed that the frequent SCCmec type in both Tabriz and Kerman cities was SCCmec III (56.86% and 55%, respectively). Conclusion: The high prevalence of MRSA makes it necessary to revisit the antibiotics administration by physicians. Indeed, periodic evaluation of antibacterial susceptibility patterns of the MRSA strains is required for efficient treatment of MRSA infections.
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Epidemiology and risk factors associated with NTM pulmonary and extrapulmonary infections in a high tuberculosis endemic Region p. 169
Sanam Rasool Wani, Chand Wattal, Reena Raveendran
DOI:10.4103/ijmm.IJMM_20_274  PMID:32883930
Introduction: Non-tuberculous mycobacteria, although identified as pathogenic to humans long time ago, are emerging as the new threat in the past two decades. Even in tuberculosis endemic country such as India, they are being isolated from the clinical specimens more often than previously. This change in trend is of concern, because they are often misdiagnosed as Mycobacterium tuberculosis or even as drug-resistant tuberculosis. Objectives: A prospective, observational study was planned to identify the frequency and risk factors associated with pulmonary and extrapulmonary non-tuberculous mycobacterial (NTM) infections. Agreement between two commercially available molecular systems, namely GenoType Mycobacteria CM assay and matrix-assisted laser desorption/ionisation time of flight mass spectrometry (MALDI TOF MS) used in the identification of mycobacterial species is also analysed. Materials and Methods: NTM isolated from pulmonary and extrapulmonary clinical specimens over a period of 1½ year was included in the study. Patient demographics were collected, and the risk factors associated with NTM infections were analyzed. NTM grown on culture was speciated using GenoType Mycobacteria CM assay (HAIN Life Sciences, Germany) and MALDI TOF MS (bioMerieux, France). Drug-susceptibility tests were done for rapid-growing NTM using E-test (bioMerieux, France). Results: Eight hundred and fifty-four mycobacteria were isolated from 5009 specimens processed during the study period. Out of the mycobacteria grown, 74 (8.7%) were NTM and 780 (91.3%) were Mycobacterium tuberculosis complex. The NTM isolated from pulmonary specimens were 46 (62.16%) and from extrapulmonary sources were 28 (37.84%). The most common species isolated from pulmonary specimens was Mycobacterium intracellulare and from extrapulmonary specimens was Mycobacterium abscessus. Concordance between the two commercial assays used for the identification was 96.49%. The most common risk factor associated with pulmonary NTM was previous lung pathology, while with extrapulmonary NTM infection was previous surgical intervention. Drug-susceptibility tests for rapid growers showed amikacin and clarithromycin as the most active drugs in vitro. Conclusions: NTM plays a significant role in causing pulmonary and extrapulmonary infections even in our part of the country with high endemicity of tuberculosis. NTM has emerged as important pathogens even in the immunocompetent patients. There is a need for rapid diagnosis and susceptibility testing of NTM to aid physicians administer timely and appropriate treatment to the patients.
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Prevalence, toxin gene profile, genotypes and antibiotic susceptibility of Clostridium difficile in a tertiary care hospital in Taif, Saudi Arabia p. 176
Taisir Saber, Yousry A Hawash, Khadiga A Ismail, Amany S Khalifa, Khalaf F Alsharif, Saleh A Alghamdi, Tamer Saber, Emad M Eed
DOI:10.4103/ijmm.IJMM_20_300  PMID:32883931
Purpose: Clostridium difficile (C. difficile) is an important causative agent of nosocomial diarrhoea and has become a major worldwide public health concern. The current study was conducted to determine the prevalence of C. difficile infection (CDI) amongst patients with nosocomial diarrhoea in a large tertiary care hospital in Taif, Saudi Arabia, and to define molecular characteristics and antimicrobial sensitivity profiles of C. difficile strains isolated from those patients. Materials and Methods: Stool specimens were collected from 456 patients and were cultured for C. difficile isolation. The isolates were subjected to multiplex polymerase chain reaction (PCR) for detecting genes encoding the toxins (toxin A, toxin B and binary toxin [CDT]), genotyping by PCR ribotyping method and antimicrobial sensitivity testing using E test strips. Results: Seventy-four C. difficile strains were recovered, of which 44 (59.5%) were A+B+CDT, 14 (18.9%) were AB+CDT, 4 (5.4%) were A+B+CDT+ and 12 (16.2%) were ABCDT. Toxigenic strains, and hence CDI, were detected in 13.6% of the patients (62/456). Fourteen different ribotypes were distinguished amongst bacterial isolates, of which ribotypes 002, 001, 017, 014 and 020 were the most prevalent (20.3%, 18.9%, 18.9%, 9.5% and 8.1%, respectively). Four isolates (5.4%) belonged to ribotype 027. All bacterial isolates showed sensitivity to metronidazole, vancomycin and piperacillin-tazobactam. The isolates exhibited resistance to linezolid (2.7%), chloramphenicol (5.4%), rifampicin (13.5%), tetracycline (21.6%), moxifloxacin (48.6%), clindamycin (54%) and imipenem (83.8%). Multiple drug resistance was observed in 56.8% of the isolates. Conclusion: Further larger studies are required for an accurate understanding of CDI epidemiology in Saudi Arabia.
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Molecular characterisation of methicillin-resistant Staphylococcus aureus isolated from patients at a tertiary care hospital in Hyderabad, South India p. 183
Ganapuram J Archana, Akhauri Yash Sinha, Madhavi Annamanedi, Kandala Pavan Asrith, Satyajit B Kale, Nitin V Kurkure, Swapnil P Doijad, Kammili Nagamani, Nagendra R Hegde
DOI:10.4103/ijmm.IJMM_20_151  PMID:32883932
Context: Infections with methicillin-resistant Staphylococcus aureus (MRSA) greatly influence clinical outcome. Molecular characterisation of MRSA can help to predict their spread and to institute treatment and hospital protocols. Aim: The aim of this study is to understand the diversity of MRSA in a tertiary care hospital in Hyderabad, India. Settings and Design: Samples collected at Gandhi Medical College, Hyderabad, and designed to assess hospital-or community-associated MRSA (HA-MRSA or CA-MRSA). Subjects and Methods: MRSA were subjected to antibiotic susceptibility testing, pulsed-field gel electrophoresis (PFGE), spa typing, multi-locus sequence typing and staphylococcal cassette chromosome–mec (SCCmec) typing. Statistical Analysis Used: Discriminatory index and 95% confidence interval. Results: Of the 30 MRSA, (a) 18 and 12 were HA-MRSA and CA-MRSA, respectively, and (b) 23.3% and 6.6% displayed induced clindamycin and intermediate vancomycin resistance, respectively. Genetic diversity was evident from the presence of (a) 20 pulsotypes, (b) eight spa types, with the predominance of t064 (n = 9) and (c) seven sequence types (ST), with the preponderance of ST22 and ST8 (9 each). ST22 and ST8 were the most prevalent among HA-MRSA and CA-MRSA, respectively. SCCmec type IV was the most frequent (n = 8). 44.4% of HA-MRSA belonged to SCCmec IV and V, whereas 33.3% of CA-MRSA belonged to SCCmec I and III; 33.3% (5/15) of the isolates harbouring the pvl gene belonged to SCCmec IVC/H. Conclusions: ST8 was a dominant type along with other previously reported types ST22, ST239, and ST772 from India. The observations highlight the prevalence of genetically diverse clonal populations of MRSA, suggesting potential multiple origins.
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Prevalence of oxacillin-susceptible methicillin-resistant Staphylococcus aureus nasal carriage and their clonal diversity among patients attending public health-care facilities p. 192
Aline Pecanha Muzy Dias, Lorrayne Cardoso Guimarães, Livia B. D V. Petrucci, Jéssica A Z. Pinheiro, Marcos Gabriel Pinheiro, Felipe Rodrigues E Silva, Helvécio C C. Póvoa, Fábio Aguiar-Alves
DOI:10.4103/ijmm.IJMM_20_157  PMID:32883933
Context: Nosocomial infections arise from many microorganisms, including Staphylococcus aureus. Aims: The aim of this study is to determine the molecular epidemiology of circulating methicillin-resistant S. aureus (MRSA) clones among patients attending community and health-care facilities in Nova Friburgo, RJ, Brazil. Methods: A total of 1002 nasal swab samples were collected from May 2010 to September 2015. S. aureus isolates were identified through phenotypic tests, submitted to antimicrobial susceptibility tests and genotypic analysis to detect mecA, panton-valentine leucocidin (PVL) genes, SCCmec, SPA and multilocus sequencing typing (MLST) typing. Results: We identified 294 (29.3%) isolates as S. aureus and 91 (9.1%) as MRSA. A total of 17 isolates did not present a correlation between phenotypic and genotypic resistance profiles. Among MRSA isolates, 17 (18.7%) carried PVL genes. A total of 20 different SPA types were determined, being grouped by MLST into eight different sequence types. ST5/t002 was the most prevalent genotype found among these isolates. Conclusions: There is a gradual colonisation shift happening in the infection pattern by S. aureus in Brazil. The Brazilian Epidemic Clone (ST239-SCCmec IIIa-PVL-) seems to be substituted by isolates from different clonal complexes, such as ST5, ST8 and ST30. The non-correlation between phenotypic/genotypic resistance profile observed in some isolates suggests the presence of other methicillin resistance mechanisms different from mecA presence or a difference in the nucleotide sequence, which prevents the primers to identify the specific region during polymerase chain reaction reactions. MRSA identification should be based on phenotypic and genotypic testing to ensure the various types of resistance mechanisms.
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Biofilm synthesis and other virulence factors in multidrug-resistant uropathogenic enterococci isolated in Northern India p. 200
Ayan Kumar Das, Mridu Dudeja, Sunil Kohli, Pratima Ray, Manvi Singh, Preet Simran Kaur
DOI:10.4103/ijmm.IJMM_19_355  PMID:32883934
Purpose: Enterococci express high degree of resistance towards wide range of antibiotics. Production of biofilm and many virulence factors along with drug resistance makes it difficult to eradicate the infection from urinary tract. The present study detected the expression of such factors including biofilm production by multidrug-resistant (MDR) enterococci. Materials and Methods: Drug susceptibility of 103 uropathogenic enterococci was performed followed by estimation of minimum inhibitory concentration of high-level gentamicin and vancomycin by microbroth dilution method. Vancomycin-resistant genes were detected by multiplex polymerase chain reaction. Production of virulence factors such as haemagglutination, caseinase, lipase, gelatinase, haemolysin and β-lactamase was detected by phenotypic methods in MDR strains. Biofilm production was detected by calcofluor-white fluorescence staining and semi-quantitative adherence assay. Results: 45% and 18.4% of the isolates were high-level gentamicin-resistant and vancomycin-resistant enterococci (VRE), respectively. vanA gene was detected in 14 and vanB gene in 5 strains. Biofilm, caseinase and gelatinase were the most expressed virulence factor. Expression of caseinase, gelatinase and lipase was significantly higher in Enterococcus faecalis (P < 0.05). Expression of haemagglutination, gelatinase and haemolysin among the vancomycin-resistant isolates was significantly higher (P < 0.05). Conclusion: VanA and vanB are the prevalent genotypes responsible for vancomycin resistance. The high prevalence of MDR enterococcal strains producing biofilm and virulence determinants raises concern. asa1, hyl, esp, gelE, cyl and other genes are known to express these factors and contribute to biofilm formation. Most uropathogenic enterococci expressed biofilm at moderate level and can be detected effectively by calcofluor-white staining. No correlation was noted between vancomycin resistance and biofilm production.
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BRIEF COMMUNICATIONS Top

Genomic evolution of severe acute respiratory syndrome Coronavirus 2 in India and vaccine impact p. 210
Jobin John Jacob, Karthick Vasudevan, Balaji Veeraraghavan, Ramya Iyadurai, Karthik Gunasekaran
DOI:10.4103/ijmm.IJMM_20_303  PMID:32883935
Recent emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and subsequent containment procedures have impacted the world as never seen before. Therefore, there is considerable curiosity about the genome evolution related to the origin, transmission and vaccine impact of this virus. We have analysed genome sequences of SARS-CoV-2 isolated from Indian patients to gain an in-depth understanding of genomic evolution and transmission in India. Phylogenetic analysis and mutation profiling revealed major lineages being evolved by characteristic mutations. As the mutation frequency in spike protein is comparatively lesser, the candidate vaccines expected to have wide coverage worldwide including India.
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Functional studies of Plasmodium falciparum's prohibitin1 and prohibitin 2 in yeast p. 213
Savitha Chellappan, Subarna Roy, Jyoti M Nagmoti, Wahida Tabassum, SL Hoti, Mrinal Kanti Bhattacharyya, Praveen Balabaskaran Nina
DOI:10.4103/ijmm.IJMM_20_28  PMID:32883936
Prohibitins (PHBs) are evolutionarily conserved mitochondrial integral membrane proteins, shown to regulate mitochondrial structure and function, and can be classified into PHB1 and PHB2. PHB1 and PHB2 have been shown to interact with each other, and form heterodimers in mitochondrial inner membrane. Plasmodium falciparum has orthologues of PHB1 and PHB2 in its genome, and their role is unclear. Here, by homology modelling and yeast two-hybrid analysis, we show that putative Plasmodium PHBs (Pf PHB1 and Pf PHB2) interact with each other, which suggests that they could form supercomplexes of heterodimers in Plasmodium, the functional form required for optimum mitochondrial function.
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INFECTIOUS DISEASE GRAND ROUND Top

Community-acquired infection caused by small-colony variant of Staphylococcus aureus p. 216
Sumit Rai, Pramod Kumar Sharma, Nirpex Tyagi, Sugandh Agarwal
DOI:10.4103/ijmm.IJMM_20_250  PMID:32883937
Staphylococcus aureus and other Gram negative bacteria produce small colony variants (SCV) which usually emerge after exposure to antimicrobials. They cause repeated infections, treatment failures and often pass unnoticed during cultures due to unusual appearance and incomplete incubation. This infectious disease grand round highlights a similar clinical case with atypical history and appearance of a SCV of S. aureus and why prolonged incubation is necessary for aspirates from patients with recurrent infections like abscesses.
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CASE REPORT: COVID-19 SERIES Top

SARS-CoV-2 viral sepsis with meningoencephalitis p. 219
Mitkumar Dharsandiya, Kinjal Shah, Ketan Patel, Tushar Patel, Amrish Patel, Atul Patel
DOI:10.4103/ijmm.IJMM_20_291  PMID:32883938
SARS-CoV-2 predominantly involves the lungs producing acute lung injury, but it can also give rise to a variety of complications involving the central nervous system, gastrointestinal system, kidney and also viral sepsis. With this case report, we are discussing unusual series of complication from acute lung injury, followed by viral sepsis then encephalitis, followed by progressive macrophage activation syndrome.
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CASE REPORTS Top

Burkholderia pseudomallei septic arthritis in Type-2 diabetes mellitus patients: Report of two cases p. 222
K Baruah Frincy, Borkakoty Biswajyoti, Satyaki Saikia, Manash P Baruah, Utpala Devi
DOI:10.4103/ijmm.IJMM_20_74  PMID:32883939
Two cases of Burkholderia pseudomallei septic arthritis are presented with a brief review of the literature. B. pseudomallei septic arthritis most commonly occurs in diabetics and other immunocompromised patients and may prove fatal despite appropriate therapy. Clinical and microbiological suspicion of B. pseudomallei infection may help in providing appropriate empirical therapy.
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Catheter-related Brevibacterium casei bloodstream infection in a child with aplastic anaemia p. 226
Sangeeta Joshi, Ruchira Misra, Suverna Kirolikar, Sujata Mushrif
DOI:10.4103/ijmm.IJMM_20_292  PMID:32883940
Brevibacteria are a part of the normal skin flora and may be dismissed in blood cultures as contaminants. They have been reported as opportunistic pathogens in immunocompromised patients. We report a catheter-related bloodstream infection with Brevibacterium casei in a 6-year-old child with aplastic anaemia. Treatment with appropriate antibiotics along with the removal of the catheter resulted in complete cure in our patient.
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Cryptococcosis in non-human immunodeficiency virus-infected patients: A clinical dilemma and diagnostic enigma p. 229
Manisha Paul, Mohit Bhatia, Ranjana Rohilla, Udayakumar Sasirekha, Neelam Kaistha
DOI:10.4103/ijmm.IJMM_20_243  PMID:32883941
Cryptococcosis is a fungal disease with worldwide distribution and wide array of clinical manifestations, caused by encapsulated basidiomycetous yeasts called Cryptococcus spp. It has traditionally been considered an opportunistic infection known to occur in immunocompromised hosts, particularly those who are infected with human immunodeficiency virus. However, this infection has also been reported in phenotypically 'normal' or otherwise clinically non-immunocompromised patients. The seemingly mysterious nature of this potentially fatal illness has always kept clinicians and diagnosticians in a dilemma. This case series reiterates this perspective.
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CORRESPONDENCE Top

Utility of polymerase chain reaction assays for confirmation of liquid culture test results for Ureaplasma spp. p. 235
Swati Khullar, Jyoti Rawre, Neena Khanna, Vishnubhatla Sreenivas, Benu Dhawan
DOI:10.4103/ijmm.IJMM_20_224  PMID:32883942
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2004 - Indian Journal of Medical Microbiology
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