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   1998| October-December  | Volume 16 | Issue 4  
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Congenital syphilis in Delhi : An analysis of data and use of an inexpensive method for detection of IgM antibody to treponema pallidum
N Berry, P Bhalla, MD Mathur
October-December 1998, 16(4):158-161
ABSTRACT: A rise in the number of congenital syphilis cases has been observed due to an increase in adult syphilis and the adoption of a broader case definition for congenital syphilis. In India, most laboratories rely on the results of Venereal Disease Research Laboratory (VDRL) test alone for the diagnosis of congenital syphilis since tests for IgM antibodies to Treponema pallidum are not available. We retrospectively analysed laboratory data for samples tested from children with clinical suspicion of congenital syphilis in six years with regard to their year wise distribution, age and sex profile, titers in VDRI positive cases and correlation of titres in infant - mother pairs. For the second part of the study, eight VDRL positive sera and two CSF samples from cases with clinical suspicion of congenital syphilis were subjected to VDRL and TPHA before and after treatment with 2-Mercaptoethanol (2-ME), in attempt to distinguish IgG and IgM class of antibodies. Forty eight (12 percent) of the 400 sera and 3(33 percent) of nine CSF samples from suspected congenital syphilis were VDRL positive. An increase in the number of cases over six years was observed. Of the 22 infant-mother pairs tested by the VDRL, 50 percent infants had greater than fourfold titre as compared to the mother. In the 8 sera and 2 CSF samples tested by VDRL and TPHA before and after treatment with 2-ME, the results of the two tests showed 87.5 percent concordance for detection of IgM antibody to T. pallidum. The modification used in this preliminary study was found useful in the distinguishing IgM class to antibodies from IgG and thus , would obviate the need for follow up serology to detect active infection can also be used for diagnosing neurosyphilis in infants with congenital disease.
[ABSTRACT]   Full text not available   
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Improving the accuracy of disk diffusion antimicrobial susceptibility testing using species-related interpretive zone break points
G Kronvall
October-December 1998, 16(4):138-142
ABSTRACT: Antimicrobial susceptibility testing by the so called quantitative disc diffusion method offers a reproducible test which can be performed in most laboratories. Standardisation of the disc method is essential. In addition, accuracy of the results is improved with the introduction of several species-related exceptions according to recommendations by NCCLS. Further species-related control of the performance in the individual laboratory is recommended using histogram analysis. Major type of interpretive errors in disc diffusion tests are described. For more specific calibration of the disc test, the so called single-strain regression analysis might be employed in collaboration with a reference authority or disc manufacturer.
[ABSTRACT]   Full text not available   
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Studies of the prevalence of acanthamoeba keratitis in and around Chennai
F Davamani, J Gananaselvan, Anandakannank, N Sridhar, T Sundararaj
October-December 1998, 16(4):152-153
ABSTRACT: Between June 1996 and November 1997, corneal scrapings from 2212 patients with keratitis attending the Govt. Regional scrapings from Hospital, Chennai were screened for different pathogens including Acanthamoeba. Of these, 563 (25.4 percent) were positive for bacterial pathogens, 660 (29.8 percent) had fungal pathogens. Acanthamoeba was present from 372 cases in 44 (2 percent) which fulfilled the criteria for suspecting Acanthamoeba keratitis. These were distributed among all ages with the maximum numbers in the 41-60 age group. Among 44 Acanthamoeba positive cases, 30 were males and 14 females. None of the patients wore contact lenses and were mostly agricultural labourers. The predisposing factors found in this study was trauma of varying degrees. Among these 44 Acanthamoeba positive cases, 18(40.9 percent) has associated bacterial pathogens while 12(27.83 percent) hand fungi and 2(4.5 percent) had both bacteria and fungi. Acanthamoeba was the only pathogen in 12(27.3 percent) cases.
[ABSTRACT]   Full text not available   
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Preservation of streptococcus pneumoniae by stand desiccation
KN Brahmadathan, R Pandian, MK Lalitha
October-December 1998, 16(4):179-180
ABSTRACT: Capsular serogroups/types 1,5,7,19 and 23 of Streptococcus pneumoniae isolated from diverse invasive pneumoccal disease were preserved in multiple aliquots by sand desiccation and stored at room temperature (RT0 and +4 degree C. All stored cultures were subcultured at 0 day, 1 week and then at 1,4,16,24, 36 and 42 months to check for their viability. All cultures stored at +4 degree C were viable upto 4 months. Cultures preserved at RT became nonviable from 16 months onwards while those stored at +4 degree C were found viable upto 42 months. Our results show that sand desiccation is an ideal alternate method for preservation of S. pneumoniae when ultra low temperature and lyophilisation facilities are not easily available.
[ABSTRACT]   Full text not available   
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Comparison of staining methods of impression smears of antral biopsies for the rapid diagnosis of helicobacter pylori
M Anjana, M Srinivasa, P Mahalakshmi, V Savitha, R Kottoor, RS Macaden
October-December 1998, 16(4):181-182
ABSTRACT: It is recognised that Helicobacter pylori is an important gastric pathogen. The widely followed rapid diagnostic test is the urease test. However, not much attention is paid to staining. In the present study , a comparative evaluation of the staining method of Gram, two-step Gram, dilute carbol-fuchsin and Giemsa on impression smears obtained from 47 patients who attended the Gastroenterology department with symptoms of peptic ulcer diseases. The results showed that all these stains performed well when compared with the unrease test. However, the two-step Gram emerged as a better and more rapid stain with least background, closely followed by dilute carbol-fuchsin.
[ABSTRACT]   Full text not available   
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Multidrug resistant salmonella typhi in Hubli [Letter]
S Nadgir, BVS Krishna, LH Halesh, SS Tallur
October-December 1998, 16(4):185-185
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Nationwide survey of laboratory practices in diagnosis of intestinal bacterial infections.
C Vaishnavi, K Thennarasu
October-December 1998, 16(4):175-178
ABSTRACT: A nationwide survey was done to analyze the prevalent screening practices for diagnosis of intestinal bacterial infections in the clinical microbiology laboratories of India. The objectives was to compare the laboratory strategies adopted by hospital based and independent laboratories. The questionnaire included queries on the types and volumes of specimens received in the laboratory for gastrointestinal infections, laboratory strategies adopted in their diagnosis, the common pathogens isolated and routinely used antimicrobials for susceptibility testing. Of the sixty respondents, 48 (80 percent) were hospital based, 11(18.3 percent) were independent and 1 (1.7 percent) was field based. Significant differences were observed in some of the practices in both the hospital based and the independent laboratories.
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Emergence of antimicrobial resistant infections in cancer patients
OC Abraham, PH Chandrasekar
October-December 1998, 16(4):143-148
ABSTRACT: Since the early 1980s, there has been a shift in the typical pathogen isolated from the febrile granulocytopenic patient, from Gram-negative bacilli to Gram-positive cocci, especially coagulase negative staphylococci and alpha - hemolytic streptococci. Methicillin resistant staphylococci and penicillin resistant streptococci are increasingly being reported. Other emerging pathogens include penicillin - resistant pneumococci, vancomycin - resistant enterococci and multiply resistant Gram-negative bacteria.
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factors affecting hemolysin expression and its associated characteristics in S. Typhimurium and S. Typhi
MK Uppal, P Rishi, RP Tiwari
October-December 1998, 16(4):169-174
ABSTRACT: Human clinical isolates (n=29) of S. typhi and S. typhimurium were screened for hemolysis and found weekly hemolytic under aerobic conditions and strongly hemolytic under microaerophilic conditions. S. typhimurium (his) mutants (n=4) remained weakly hemolytic even under microaerophilic conditions. Hemolytic activity in salmonellae was found to be thermoregulated and chromosome mediated. Addition of iron-chelator to growth medium was inhibitory to hemolysin activity and to congo red dye binding at 37 degree C. S. typhimurium cell adherence to enterocytes was more to the posterior portion of small intestine. Minor differences were observed in phagocytic uptake and intracellular survival rates of S. typhimurium 98 and S. typhimurium TA 98 (mutant). The up regulation in growth of both the phagocytosed bacteria was observed upto 3 hours and thereafter drop in bacterial number was seen. Acid Tolerance Response was higher in adapted cell (pH 5.8) as compared to the unadapted cells (pH 7.2) shifted to pH 3.3. In view of these findings, the hemolysin activity in S. typhimurium appeared to be critical for lysis of phagocytic vacuole where they survive acidic conditions and multiply after invasion of epithelial cells which they penetrate for intracellular survival.
[ABSTRACT]   Full text not available   
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Gas gangrene and related infection in a tertiary care hospital
R Chaudhary, B Dhawan
October-December 1998, 16(4):165-168
ABSTRACT: The microbiological data of 23 patients who developed gas gangrene during a 5 year period from January 1992 to December 1996 was evaluated. The wound discharge yielded clostridial bacteria in 26 percent and non-clostridial aerobes and anaerobes in 56.5 percent. Clostridium perfringens was found to be the commonest clostridial isolate whereas Escherichia coli was the commonest in the non-clostridial group. Among the 23 patients reported, gas gangrene due to non-clostridial organisms was attributable in 13 patients. These non-clostridial gas gangrene cases were clinically indistinguishable from the clostridial infections. These infections possibly have the same fulminant course and thus need immediate radical treatment as the clostridial infections.
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Testing pooled sera for HCV antibody : an economic consideration
S Christopher, PG Babu, P Abraham, T Subramaniam, R Pulimood, TJ John, S Ratnam
October-December 1998, 16(4):154-157
ABSTRACT: The need for the screening of blood donors for hepatitis C virus antibody (anti-HCV) is increasingly being recognised in developing countries. However, it has not yet become the standard practice due to the high cost of anti-HCV testing. In an attempt to reduce the cost of testing, we evaluated the reliability of testing pooled sera. A total of twenty serum pools each containing two, three, five and ten sera were tested using a second generation anti-HCV test kit (Abbott Diagnostics, North Chicago, III). Each serum pool contained one anti-HCV positive serum of low, medium or high antibody content. All pools of two sera tested positive for anti-HCV, whereas pools of 3 or more sera were found to be unsatisfactory. This data showed pools of two sera can be tested reliably, and this approach would significantly reduce the cost of anti-HCV testing, without compromising on the sensitivity.
[ABSTRACT]   Full text not available   
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Retrospective evaluation of the duke criteria for infective endocarditis in the Indian setting
AK Bilotikar, DVS Sarma, B Bhushan, V Lakshmi
October-December 1998, 16(4):162-164
ABSTRACT: A definite diagnosis of Infective Endocarditis (IE) helps management protocols. A total of 350 blood cultures were received from 151 suspected cases of IE. The newly proposed Duke diagnostic criteria for IE were retrospectively applied for these cases. Out of the 151 suspected cases, a diagnosis of definite IE was possible in 23 (14.56 percent). There were 13 (9.27 percent) cases of possible IE. The remaining cases did not meet the requirements of the criteria. The predominant organisms isolated were viridans streptococci 8 (36.36 percent) and Staphylococcus aureus, 8 (36.3 percent).
[ABSTRACT]   Full text not available   
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Comparison of DNA amplification and IGM assays for the detection of mycoplasma pneumoniae in primary atypical pneumonia
C Rodrigues, K Narra, R Nukala, S Menon, K Sheth, A Mehta
October-December 1998, 16(4):149-151
ABSTRACT: The aim of this study was to determine the sensitivity of two different methods, DNA amplification and ELISA for the detection of Mycoplasma pneumoniae from clinical samples. Sputum / BAL were obtained from 25 patients and 25 throat swabs from healthy individuals for DNA amplification and serum from all patients and controls for IgM levels respectively. Mpn 38 and Mpn 39 primers were used to amplify a 950 bp fragment of tuf gene in M-pneumoniae. Two patients were positive by ELISA and also for DNA amplification. None of the ELISA positives were negative by DNA amplification and none of the ELISA negatives were positive for M. pneumoniae by DNA amplification. Thus, in a country like India where cost remains a major constraint, ELISA is an adequate and rapid method for the detection of M. pneumoniae.
[ABSTRACT]   Full text not available   
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Hypomelanotic cryptococcus neoformans as a cause of meningitis in an aids patient
MU Tendolkar, AS Gogate
October-December 1998, 16(4):183-184
ABSTRACT: Phenoloxidase, the enzyme responsible for the production of diagnostic pigment by Cryptococcus neoformans, is also a virulence determinant. We report the isolation of a strain of C. neoformans which showed very poor pigment formation on bird seed agar. This strain was recovered from the CSF of a patient with AIDS.
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2004 - Indian Journal of Medical Microbiology
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