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Coverpage
April-June 2017
Volume 9 | Issue 2
Page Nos. 39-89

Online since Wednesday, May 24, 2017

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EDITORIAL  

State of the globe: Hepatitis C – Opportunistic versus organized screening p. 39
Sunil Kumar Raina, Vivek Chauhan, Suman Thakur
DOI:10.4103/jgid.jgid_71_17  PMID:28584452
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EXPERT COMMENTARY Top

Reflections on the ebola public health emergency of international concern, Part 1: Post-Ebola syndrome: The silent outbreak p. 41
Stanislaw P Stawicki, Richard P Sharpe, Sagar C Galwankar, Joan Sweeney, Noel Martins, Thomas J Papadimos, Donald Jeanmonod, Michael S Firstenberg, Lorenzo Paladino, Bhakti Hansoti, Manish Garg
DOI:10.4103/jgid.jgid_20_17  PMID:28584453
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Reflections on the ebola public health emergency of international concern, part 2: The unseen epidemic of posttraumatic stress among health-care personnel and survivors of the 2014–2016 Ebola outbreak p. 45
Lorenzo Paladino, Richard P Sharpe, Sagar C Galwankar, Farhad Sholevar, Christine Marchionni, Thomas J Papadimos, Elisabeth Paul, Bhakti Hansoti, Michael Firstenberg, Manish Garg, Mindy Watson, Ric A Baxter, Stanislaw P Stawicki, On behalf of The American College of Academic International Medicine (ACAIM)
DOI:10.4103/jgid.jgid_24_17  PMID:28584454
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ORIGINAL ARTICLES Top

Hepatitis C virus: Unnoticed and on the rise in blood donor screening? A 5 years cross-sectional study on seroprevalence in voluntary blood donors from central India p. 51
Purti Agrawal Saini, Preeti Rihal Chakrabarti, Amit V Varma, Shankhini Gambhir, Gargi Tignath, Priyanka Gupta
DOI:10.4103/0974-777X.205172  PMID:28584455
Context: The ultimate goal of a blood transfusion service is the provision of safe and adequate supply free from transfusion-transmitted infections (TTIs). TTIs not only threaten the recipient's safety, but they also increase disease burden. Seroprevalence of TTIs in healthy blood donors indirectly reflects the prevalence of these infections in the general healthy population. Aim and Objectives: To study the seroprevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) in healthy donors at a tertiary care hospital-based blood bank. To know the yearly and age-group prevalence of these TTIs as compared with other studies across India. Settings and Design: This is 5 years observational cross-section study conducted in a tertiary hospital-based teaching institute of Central India (Malwa region). Materials and Methods: The results of serological testing of TTIs and donor variables were analyzed during 2011–2015. Statistical Analysis Used: Chi-square test and Chi-square for trend analysis on TTIs prevalence. Results: A total of 58,998 donors were screened for TTIs with dominance of male donation (99.7%). The overall cumulative seroprevalence was 1.14% in our study. The seroprevalence of HIV, HBV, and HCV was 0.09%, 0.98%, and 0.07%, respectively. We found a statistically significant increasing trend for HCV seropositivity during the study. Conclusion: Our study reflects an increasing trend of HCV seroprevalence over time. Thus, efforts are needed to increase the awareness and to educate the population in reducing risk factors for HCV infection.
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Isolation rate and clinical significance of uropathogens in positive urine cultures of hemodialysis patients p. 56
Katerina G Oikonomou, Adib Alhaddad
DOI:10.4103/0974-777X.204691  PMID:28584456
Background: Hemodialysis (HD) patients are known to be vulnerable to infections. However, there are limited data on the urine microbiology spectrum among patients with end-stage renal disease and on the development of antimicrobial resistance of uropathogens in these patients. Materials and Methods: A single-center, retrospective study was conducted to assess the spectrum and antimicrobial resistance profile of microorganisms isolated in urine cultures of HD patients who were hospitalized between September 2008 and August 2015 with an admitting diagnosis of fever, sepsis, or urinary tract infection. Characteristics of patients were recorded, and associations between the aforementioned parameters were assessed with Fisher's exact test. Results: We included 75 HD patients (33 males, mean age 73.6 ± 16.6 years) with positive urine cultures. Despite urine culture positivity, the urinary tract was the confirmed source of infection in only 31 (41.3%) patients. Among the different pathogens, Escherichia coli was the predominant microorganism. Identification of E. coli as the involved uropathogen was associated neither with a growth of ≥105 CFU/ml, presence of fever, sepsis, urinary catheter use nor with higher antimicrobial resistance. E. coli growth, however, was significantly associated with polycystic kidney disease (P = 0.027). Extended antimicrobial resistance was noted in 29 (38.7%) patients but was associated neither with higher incidence of fever or sepsis nor with urinary catheter use. Conclusions: In our series of HD patients with positive urine cultures, the isolation rates of different uropathogens do not seem to differ from the most commonly encountered ones in nondialysis patients although resistance to antimicrobials may be more frequently observed.
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Analysis of the clinical profile in patients with Plasmodium falciparum malaria and its association with parasite density p. 60
Praveen Mangal, Shilpa Mittal, Kamal Kachhawa, Divya Agrawal, Bhabagrahi Rath, Sanjay Kumar
DOI:10.4103/0974-777X.201626  PMID:28584457
Background: Malaria remains a major health hazard in the modern world, particularly in developing countries. In Plasmodium falciparum malaria, there is a direct correlation between asexual erythrocytic stage parasite density and disease severity. Accordingly, the correlations between parasite density and various clinical presentations, severity, and outcome were examined in falciparum malaria in India. Materials and Methods: The study was conducted in a tertiary health-care center in North India. Of 100 cases of falciparum malaria, 65 patients were male and 35 were female. A total of 54 patients were in the uncomplicated group and 46 patients were in the complicated malaria group. Results: Fever, anemia, icterus, splenomegaly, hepatomegaly, and hepatosplenomegaly were common clinical findings. All clinical findings were significantly more common in the complicated malaria group and patients with a high parasite density than in the uncomplicated group and those with a low parasite density. All patients in the uncomplicated malaria group had a parasite density of <5% while most patients in the complicated malaria group had a parasite density of >5%, and the difference between groups was statistically significant. The incidence of cerebral malaria was significantly higher in cases with a high parasite density; 58.33% mortality was observed in these cases. Cerebral malaria and hyperbilirubinemia was the most frequently encountered combination of complications. Conclusions: In P. falciparum malaria, parasite density was associated with complications and poor clinical outcomes. These results may inform treatment decisions and suggest that a threshold parasite density of 5% is informative.
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REVIEW ARTICLE Top

Epidemiology of rotavirus in the Iranian children: A systematic review and meta-analysis p. 66
Seyed Hamid Reza Monavari, Shima Hadifar, Shayan Mostafaei, Ali Miri, Mohsen Keshavarz, Farhad Babaei, Mohsen Moghoofei
DOI:10.4103/0974-777X.205173  PMID:28584458
Rotavirus is associated with increased risk for severe diarrhea in infants and young children worldwide. This systematic review and meta-analysis was performed to determine the prevalence rate of rotavirus from different parts of Iran and provide an overall relative frequency (RF) for Iran. We performed a systematic literature review from several databases including PubMed, ISI Web of Science, Scopus, OVID, MAG IRAN, IranMedex, and Iranian Scientific Information Database. We searched the following keywords: “rotavirus,” “rotavirus infection,” “acute gastroenteritis,” “diarrhea,” “children,” “infant,” and “Iran.” The purpose of this study was to report the prevalence of rotavirus with the application of meta-analysis. We selected 43 researches out of 1147 for our study. From all the samples, the pooled estimate of prevalence (95% confidence interval) =39.9% (0.396%–0.409%) were rotavirus positive. It should be noted that rotavirus infection's RF varied from 6.4% to 79.3% in Birjand and Tehran Provinces, respectively. Thereupon, it is divergent in different studies. According to our study result, rotavirus RF has a wide range in Iran and is associated with diarrhea in children. Thus, further researches should be taken to minimize the emergence and transmission of rotavirus.
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MICROBIOLOGY REPORT Top

Susceptibility pattern of enterococci at tertiary care hospital p. 73
Sadhana Sachan, Vinita Rawat, Umesh , Mukesh Kumar, Tripta Kaur, Preeti Chaturvedi
DOI:10.4103/0974-777X.194371  PMID:28584459
The study was aimed to characterize enterococci from various clinical specimens, to determine the antimicrobial susceptibility pattern, and to explore the association between virulence factors and antimicrobial resistance. A total of 283 clinical enterococcal isolates were speciated and subjected to antimicrobial susceptibility testing. Virulence factors (hemolysin, gelatinase, and biofilm production) were detected phenotypically. Of the 283 enterococci isolated, 12 species were identified; predominant species were Enterococcus faecalis (82.33%). High-level gentamicin (HLG) and vancomycin resistance were observed among 55.57% and 6.01% of enteroccal isolates, respectively. All vancomycin-resistant enterococci (VREs) were E. faecalis and had VanA phenotype and genotype. Hemolysin, gelatinase, and biofilm production were seen in 15.90%, 12.36%, and 13.43% of enterococcal isolates, respectively. Vancomycin and HLG resistance were observed in 0.35% and 61.86% of the enterococcal isolates producing virulence factors. Isolates resistant to HLG but susceptible to vancomycin expressed more virulent factors. Further research is required to reveal the complex interplay between drug resistance and virulence factors.
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CASE REPORTS Top

Hemophagocytic lymphohistiocytosis associated with anaplasmosis p. 76
Tamara M Johnson, Melinda S Brown, Mohamed Rabbat, Jihad Slim
DOI:10.4103/jgid.jgid_116_16  PMID:28584460
Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome characterized by unregulated macrophage and T-lymphocyte activation resulting in cytokine overproduction and subsequent histiocytic phagocytosis. Variant infections, particularly viruses have been postulated as the inciting factor for this potentially fatal disease. Herein, we will report a case of HLH associated with anaplasmosis.
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Infective endocarditis due to Abiotrophia defectiva and its feared complications in an immunocompetent person: Rare, but real p. 79
Mohan Rudrappa, Laxmi Kokatnur
DOI:10.4103/0974-777X.204693  PMID:28584461
Abiotrophia defectiva is nutritional deficient streptococci that cannot be cultured on routine culture medias. Even though fastidious in growth requirement, it is a virulent bacterium preferentially affecting endovascular structures and is implicated in many culture-negative endocarditis cases. Unlike other organisms, it is known for heart valve destruction leading to heart failure and excessive embolization rates. It's inherent resistance to routinely used antibiotics also contributed to increased mortality and morbidity in affected individuals and warrants timely diagnosis and prompt treatment. Our patient, a previous healthy individual, acquired this rare bacterium from intravenous drug abuse and developed infective endocarditis with valve destruction, heart failure, and distal embolization to multiple organs. He underwent multiple surgeries including mitral valve replacement and embolectomy with clinical improvement. Our case reiterates the possibility of rare cause of common diseases and raises awareness of infective endocarditis caused by A. defectiva among medical professionals.
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Aeromonas salmonicida bacteremia associated with chronic well water consumption in a patient with diabetes p. 82
Christine Ann Moore, Muhammad F Khalid, Parasbhai D Patel, Jack S Goldstein
DOI:10.4103/jgid.jgid_147_16  PMID:28584462
Aeromonas salmonicida is associated with superficial skin infections in fish. Its virulence factors allow colonization of water including surface water such as salt water, beaches, and fresh water wells. Moreover, it is possible for immunocompromised patients to develop invasive disease after chronic exposure to Aeromonas spp. through contaminated water. While there are reports of Aeromonas spp. bacteremia following water ingestion, there have been no reports of A. salmonicida bacteremia from water consumption. We report the first case of A. salmonicida bacteremia in a patient with diabetes due to chronic consumption of well water.
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LETTERS TO EDITOR Top

Native valve endocarditis in a dialysis patient by Achromobacter xylosxidans, a rare pathogen p. 85
Shweta Kumar, Jagroop Khaira, Damodar Penigalapati, Apurva Apurva
DOI:10.4103/0974-777X.204692  PMID:28584463
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Strongyloides stercoralis infection: A case series from a tertiary care center in India p. 86
Nitin Gupta, Aashish Choudhary, Bijay Ranjan Mirdha, Pratibha Kale, Kamla Kant, Arnab Ghosh, Nishant Verma
DOI:10.4103/0974-777X.204694  PMID:28584464
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Profile of helminthic infections in patients attending a tertiary care hospital with emphasis on immunocompromised patients p. 87
Vanathy Kandasamy, Nonika Rajkumari, Subhash Chandra Parija, Palanivel Chinnakali, VS Negi
DOI:10.4103/jgid.jgid_174_16  PMID:28584465
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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008