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   2004| January-March  | Volume 22 | Issue 1  
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Laboratory markers associated with progression of HIV infection
V Gupta, S Gupta
January-March 2004, 22(1):7-15
Infection with HIV may develop to AIDS at different rates in different individuals, with a spectrum varying from rapid progression to long term non-progression. The variable course of HIV-1 infection causes emotional trauma for the infected person and complicates the design and interpretation of therapeutic trials because of unrecognized differences in prognosis. Thus it is essential to have tests which can accurately assess the stage of infection in an individual, as well as predict its course and monitor its progression. These laboratory tests are very valuable during the period of clinical latency and subsequently supplement various clinical parameters.
  20,117 825 -
Prevalence of bacterial and fungal agents causing lower respiratory tract infections in patients with human immunodeficiency virus infection
VV Shailaja, LA Pai, DR Mathur, V Lakshmi
January-March 2004, 22(1):28-33
PURPOSE: This study was designed to document the prevalence of HIV associated respiratory infections in Hyderabad. Such studies have not been worked out before in this region. METHODS: The study included specimens from 130 patients with complaints suggestive of lower respiratory tract infection. Among them 100 were HIV reactive and 30 were HIV nonreactive. Both the expectorated as well as induced sputum samples were collected and processed to examine for the bacterial and fungal pathogens including Pneumocystis carinii. RESULTS: Sputum samples from 63% of HIV reactive and 33.3% of HIV nonreactive patients were culture positive. In all, there were 70 pathogens isolated from the HIV reactive subjects, 44.3% were bacteria, 42.9% were Mycobacteria and 12.8 % were fungi. CONCLUSIONS: Lower respiratory tract infection is a common problem among HIV reactive patients and majority are bacterial infections. Polymicrobial isolation was observed only among the HIV reactive patients. PCP was not documented in our series.
  13,426 737 6
Trichosporon asahii as an emerging etiologic agent of disseminated trichosporonosis: A case report and an update
A Chowdhary, S Ahmad, ZU Khan, DC Doval, HS Randhawa
January-March 2004, 22(1):16-22
PURPOSE: To report a fatal case of disseminated trichosporonosis caused by Trichosporon asahii in a patient with acute myeloblastic leukemia (AML) and to present an update on systemic trichosporonosis with special reference to India. METHODS: The diagnosis was based on repeated demonstration of budding yeast cells and arthroconidia by direct microscopic examination of sputum and by isolation of T. asahii in culture of sputum and blood. The update is largely based upon literature search in Medline and Review of Medical and Veterinary Mycology. RESULTS: A 41-year-old male presented with acute myeloblastic leukemia, cough and fever. He had received cytotoxic drug therapy, broad spectrum antibiotics and was neutropenic. Trichosporon asahii was repeatedly demonstrated in his sputum by direct microscopy and culture, and also isolated from blood. It was identified by appropriate morphological and physiological characteristics viz., arthroconidium formation, diazonium blue B reaction, urease activity and assimilation of carbon and nitrogen compounds. The identification was confirmed by PCR amplification and direct DNA sequencing of internally transcribed spacer (ITS) 1 and ITS2 of rDNA. CONCLUSION: With greater awareness of etiologic significance of T.asahii, trichosporonosis is likely to be recognised more frequently than apparent from the available published reports.
  11,868 474 25
Effect of gamma radiation on survival of campylobacters in various food samples
SP Bhavsar, M Baserisalehi, BP Kapadnis
January-March 2004, 22(1):39-43
PURPOSE: Campylobacter spp. is a major food borne pathogen and shows resistance towards gamma radiation. In the present study, effect of gamma radiation was assessed on the indigenous strains of Campylobacter spp. inoculated in food and water samples. METHODS: Campylobacter spp. were isolated from river water and faeces of various birds and animals. The growth rate was studied for these isolates by propagating them in Kapadnis-Baseri medium. The survival of Campylobacter spp. inoculated in food and water samples was tested after exposing them to gamma radiation. RESULTS: The isolates survived well in meat and milk samples and were sensitive to 1.8 KGy dose of gamma radiation, which lies with in the FDA limit. The effect of radiation on Campylobacter spp. varied with the species and the type of food. CONCLUSIONS: The results obtained suggest that the dose of gamma radiation should be standardized depending on the Campylobacter spp. and the type of food that is being processed.
  12,079 234 1
A standard screening test for the early and rapid diagnosis of leptospirosis
S Chandrasekaran, S Gomathi
January-March 2004, 22(1):23-27
PURPOSE : To perform dark field microscopy (DFM) for detection of Leptospira and to validate the results using Leptospira IgM antibody SERION ELISA test. METHODS : After differential centrifugation of Ruys, DFM was done to demonstrate Leptospira in the blood and SERION ELISA was done for Leptospira IgM antibody in single or paired serum samples. One hundred and eleven cases (39 adults and 72 children) of suspected leptospirosis were included in the study. RESULTS : Anicteric cases accounted for 66.7% (26/39) of adults and complications involving brain, liver, kidney and eyes were seen in 33.3% (13/39). In children, 90.3% (65/72) were anicteric and involvement of brain and liver was seen in 9.7% (7/72) cases. On testing 60 single samples of blood from 23 adults and 37 children, DFM exhibited greater sensitivity of 93.3% (56/60) than that of SERION ELISA for Leptospira IgM antibody (33.3%, 20/60). It was observed that the positivity of DFM decreased from 100% (15/15) to 90.9% (10/11) with increase in the duration of infection for more than one week. ELISA for Leptospira IgM, done on 51 paired blood samples, was positive in 64.7% (33/51) cases when both (first and second) samples were tested while in 45.1% (23/51) cases was positive with first sample alone. 58.8%(30/51) cases were positive by testing second sample. DFM results on paired blood samples showed persistence of Leptospira in 92.9% of cases. CONCLUSION : This study shows the validation of DFM results by SERION ELISA for Leptospira IgM antibody, based on which we recommend that DFM can serve as a standard screening test for early and rapid diagnosis of leptospirosis.
  10,524 707 5
Dengue haemorrhagic fever: A global challenge
UC Chaturvedi, R Shrivastava
January-March 2004, 22(1):5-6
  10,458 751 28
Evaluation of immunogenicity and safety of Genevac B: A new recombinant hepatitis b vaccine in comparison with Engerix B and Shanvac B in healthy adults
V Vijayakumar, R Hari, R Parthiban, J Mehta, SP Thyagarajan
January-March 2004, 22(1):34-38
PURPOSE: Genevac B, a new indigenous recombinant hepatitis B vaccine was evaluated for its immunogenicity and safety in comparison with Engerix B (Smithkline Beecham Biologicals, Belgium) and Shanvac B (Shantha Biotechnics, India) in healthy adult volunteers. METHODS: While 240 study subjects were included in the Genevac B group, 80 each were the subjects for Engerix B and Shanvac B. A three dose regimen of 0,1,2 months was adopted with 20 gm dosage uniformly in all the three groups. Vaccinees were assessed during prevaccination, followup and post vaccination periods for clinical, haematological, biochemical and immunological parameters for safety and immunogenicity. RESULTS: Successful follow-up in all parameters for four months could be achieved in 92.5% (222/240) for Genevac B study subjects and the same was 85% (68/80) and 80% (64/80) for Engerix B and Shanvac B respectively. While 100% seroconversion was observed in all the three groups, the rate of seroprotectivity was 99.5% by Genevac B, 98.5% by Engerix B and 98.4% for Shanvac B. However the difference was not statistically significant (p>0.05). The GMT values of anti HBs after one month of completion of the vaccination were 735.50, 718.23 and 662.20 mIU/mL respectively. No systemic reaction was either seen or reported by the volunteers during the vaccination process of Genevac B and other two vaccines. Clinical, haematological and biochemical safety parameters remained within normal limits throughout the study period. CONCLUSION: The study confirms that Genevac B, the new recombinant Hepatitis B vaccine has the acceptable international standards of safety and immunogenicity.
  10,107 336 14
Diagnosis of bacterial vaginosis in a rural setup: Comparison of clinical algorithm, smear scoring and culture by semiquantitative technique
PS Rao, S Devi, A Shriyan, M Rajaram, K Jagdishchandra
January-March 2004, 22(1):47-50
This study was undertaken to estimate the prevalence of bacterial vaginosis (BV) and other sexually transmitted infections (STIs) in a rural set up and compare the smear scoring system to that of culture by semiquantitative technique. A total of 505 married women, who were in sexually active age group of 15-44 years, were selected from three different villages. High vaginal swabs, endocervical swabs, vaginal discharge and blood were collected and processed in the laboratory. Overall prevalence of 29% reproductive tract infection was detected. Endogenous infection was commonly observed (27.92%), and very low prevalence of STIs (Trichomonas 1.18%, Syphilis 0%, Gonorrhea 0%) was detected. Diagnosis of BV was possible in 104 (20.5%) women by smear alone and 88 (17.42%) women by semiquantitative culture.
  9,258 454 12
Intestinal parasitic infection and total serum IgG in asymptomatic adult males in an urban slum and efficacy of antiparasitic therapy
S Nagaraj, R Raghavan, R Macaden, AV Kurpad
January-March 2004, 22(1):54-56
Malnutrition is thought to potentiate the polyclonal stimulation of IgE by parasites. This diminishes immunity due to the decrease in specific anti-parasitic IgE. Prevalence of intestinal parasitic infections in chronically undernourished, asymptomatic adult males from a slum and efficacy of anti-parasitic therapy and its effect on total serum IgE were evaluated. Stool specimens from 51 subjects were examined. Anti-helminth and anti-protozoan therapy consisted of oral, single dose albendazole (400mg) and tinidazole (2g) respectively. Total serum IgE was measured. 23 (45.1%) subjects were positive. Albendazole and tinidazole cleared intestinal parasites but had no significant effect on total serum IgE levels.
  9,047 229 2
Comparison of rapid colorimetric method with conventional method in the isolation of mycobacterium tuberculosis
A Oberoi, H Kaur
January-March 2004, 22(1):44-46
The aim of the study was to evaluate two methods (colorimetric and conventional) for isolation of Mycobacterium tuberculosis. A total of 500 clinical specimens were processed by modified Petroff's method and then inoculated into MB/BacT-240 system bottles and on LJ medium slopes. The specimens included 242 sputum, 95 gastric aspirates, 47 pleural fluids, 45 CSF, 32 urine, 18 pus, 11 bronchoalveolar lavage, 3 tissue, 2 stool, 2 lymphnode specimens, 2 synovial fluid and 1 bronchial wash specimens. The isolation rate was 16.4% by the colorimetric method and 2.2% by the conventional method. The mean detection time was 16 days and 26 days respectively. Among 36 direct smear positive samples, 63.9%(23/36) and 30%(11/36) were positive by colorimetric and conventional methods respectively. Out of 464 direct smear negative samples 12.9%(60/464) and 0.6%(3/464) were positive by colorimetric and conventional methods respectively. Therefore, colorimetric method enables rapid detection leading to early diagnosis and drug susceptibility testing.
  8,552 320 4
Neonatal outbreak of salmonella worthington in a general hospital
VA Muley, SS Pol, VB Dohe, RP Nagdawane, VP Arjunwadkar, DP Pandit, RS Bharadwaj
January-March 2004, 22(1):51-53
This is a report of an outbreak of Salmonella worthington in neonates at Sassoon General Hospitals, Pune, which occurred during August and September 2000. A total of 148 blood, 4 CSF and 6 stool specimens were received from neonates admitted to the hospital. Salmonella worthington could be isolated from 17 clinical specimens [15 blood (10.8%), 1 CSF (25%) and 1 stool (16.6%) sample]. Environmental swabs were also processed. An attempt was made to detect carriers in health care personnel. However, no source or carrier of Salmonella worthington in the hospital environment could be identified. Intensive cleaning measures and fumigation were undertaken. All these measures succeeded in aborting the outbreak.
  6,548 178 1
Superiority of dat over elisa as a diagnostic and seroepidemiological tool for the diagnosis of Indian kala-azar
RK Goyal, TM Mohapatra
January-March 2004, 22(1):57-60
The aim of this study was to evaluate two methods for the diagnosis of Kala-azar. The sera of 160 individuals were evaluated by ELISA using soluble antigen and direct agglutination test (DAT) for Kala-azar. These were categorized as 100 cases of clinically and parasitologically confirmed Kala-azar and 60 controls. The controls included clinically suspected but parasitologically not confirmed Kala-azar patients (10), endemic normals (15), non-endemic normals (19), typhoid fever (10) and malaria (15). The positivity rate amongst the clinically and parasitologically confirmed Kala-azar patients by ELISA and DAT were 93% and 98% respectively. Out of 10 clinically suspected Kala-azar cases three showed positive reaction in ELISA and two in DAT. Of the endemic normals, one case was found positive by both the tests whereas ELISA was found positive in one additional case. DAT did not show any cross reactivity with malaria while ELISA was found positive in one case. Both endemic normals and typhoid fever cases showed no reaction by both tests. ELISA showed a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 93%, 90%, 93% and 90% respectively while for DAT these values were 98%, 95%, 98 and 95% respectively. The diagnostic accuracy for ELISA and DAT was found to be 91.9% and 96.9%, respectively. The present study shows that DAT is a simple, sensitive, specific and cost effective test with high PPV and NPV along with approximately 97% diagnostic accuracy and is comparable to ELISA. It may be applied for the routine diagnosis as well as seroepidemiological study of Kala-azar.
  6,405 215 1
The seroepidemiology of rubella in Amritsar (Punjab)
N Singla, N Jindal, A Aggarwal
January-March 2004, 22(1):61-63
Seroprevalence of Rubella was determined in 580 women including 80 women of medical community of district Amritsar, by ELISA test. The overall Rubella IgG seropositivity was 68.8% while in women of medical community it was 80%. Maximum number of women were seropositive (77.2%) in age group 26-35 years. Significantly higher rates were observed in women of urban areas and those belonging to lower socioeconomic class. Although the incidence of seropositivity was more in women with history of adverse pregnancy outcome than those with normal obstetric performance, the difference was statistically not significant (p > 0.05). Serologically, immune status showed poor correlation with history of past Rubella virus like infection.
  5,851 243 5
HIV-1 infection in a patient of acute lymphocytic leukaemia missed by HIV-spot and HIV-scan rapid tests
S Singh, V Kumari, N Singh
January-March 2004, 22(1):64-65
A case of HIV-1 infection, presumably acquired through unsafe blood transfusion in an acute lymphocytic leukemia (ALL) patient, is reported here in whom the two rapid HIV antibody detection kits (HIV-spot and HIV-Scan) failed to diagnose the infection while the sample was strongly positive in microwell ELISA (detect- HIV) on the same day and was confirmed by western blot assay (NEW LAV BLOT-1). However, repeat sample after 15 days was found positive in all the tests. Though the rapid tests are preferred over microwell ELISA because of ease of performance and rapid availability of results, this report confirms low sensitivity of the two rapid tests. This suboptimal sensitivity, particularly in cases of early seroconversion, therefore, must be borne in mind for screening the blood and organ donors under strategy-I.
  5,289 114 1
Evaluation of the direct acridine orange staining method for diagnosis of malaria
S Nandwani
January-March 2004, 22(1):68-68
  5,061 242 -
Simple broth-disk technique for the detection of methicillin resistance in staphylococcus aureus
V Nishi, BR Raman, C Yengkokpam, GK Bhat
January-March 2004, 22(1):69-70
  4,476 258 1
Acinetobacter septicaemia in neonates
CS Vinodkumar, YF Neelagund
January-March 2004, 22(1):71-71
  4,490 218 5
Shortcomings require internal quality control
BR Mirdha
January-March 2004, 22(1):72-72
  4,360 157 -
Seroprevalence of HIV in a hospital based population and blood bank donors in South India
MU Rasheed, K Hemalatharao
January-March 2004, 22(1):66-66
  4,258 139 1
Seroprevalence of leptospirosis in clinically suspected cases in Chennai city
N Jeyakumar, AA Khan, P Dhasarathan, AJ AR Singh
January-March 2004, 22(1):67-67
  3,767 165 2
Rapid and efficient screening for malarial parasites using acridine orange staining
N Hemvani, T Mani, DS Chitnis
January-March 2004, 22(1):73-73
  3,653 168 -

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

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