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April-June 2015 Volume 7 | Issue 2
Page Nos. 53-94
Online since Tuesday, May 19, 2015
Accessed 51,299 times.
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EDITORIAL |
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State of the globe: Ebola outbreak in the western world: Are we really ready? |
p. 53 |
Miguel Reina-Ortiz, Ismael Hoare, Vinita Sharma, Ricardo Izurieta DOI:10.4103/0974-777X.157235 PMID:26069422 |
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POINT OF VIEW |
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2015 resurgence of influenza a (H1N1) 09: Smoldering pandemic in India? |
p. 56 |
Baijayantimala Mishra DOI:10.4103/0974-777X.157236 PMID:26069423 |
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ORIGINAL ARTICLES |
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Utility of line probe assay for the early detection of multidrug-resistant pulmonary tuberculosis |
p. 60 |
K Madhuri, Smita Deshpande, Sujata Dharmashale, Renu Bharadwaj DOI:10.4103/0974-777X.157237 PMID:26069424Background: Despite endorsement of the line probe assay (LPA) for the diagnosis of drug-resistant pulmonary tuberculosis patients, there is limited data available on the performance of LPAs in India, especially from high burden states like Maharashtra, for the early diagnosis and detection of drug resistance, in order to initiate timely and appropriate treatment. Objective: To evaluate the utility of the line probe assay (LPA) for the early diagnosis of drug-resistant pulmonary tuberculosis as compared to the 'Gold standard' 1% proportion method (PM). Materials and Methods: A total of 687 patients suspected of pulmonary tuberculosis were screened. One hundred samples (95 sputum and 5 BAL), positive for Acid Fast Bacilli (AFB) by Ziehl Neelson (ZN) smears, were included in the study. Digested and decontaminated specimens were subjected directly to the LPA (Genotype [email protected] plus assay) and were processed in parallel using the conventional culture on the Lowenstein-Jensen (LJ) medium followed by drug susceptibility testing (DST) using the PM. Results: All the 100 samples gave interpretable results on LPA with a turnaround time of 24-48 hours as opposed to six to eight weeks taken by the 1% proportion method. Sensitivity for the detection of rifampicin, isoniazid, and multidrug resistance (MDR) was 98.1, 92.1, and 95%, respectively, with a specificity of 97.8% for rifampicin and 98.33% for MDR detection. It also had the additional advantage of allowing a study of mutation patterns. Conclusions: High performance characteristics and a short turnaround time makes LPA an excellent diagnostic tool, for an early and accurate diagnosis, in a high MDR- TB-prevalent region, as reflected from our data. |
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Utility of MPT64 antigen detection for rapid confirmation of mycobacterium tuberculosis complex |
p. 66 |
Jyoti Arora, Gavish Kumar, Ajoy Kumar Verma, Manpreet Bhalla, Rohit Sarin, Vithal Prasad Myneedu DOI:10.4103/0974-777X.154443 PMID:26069425Background: Rapid differentiation of the Mycobacterium tuberculosis complex (MTBC) and mycobacteria other than tuberculosis (MOTT) is crucial to facilitate early and effective treatment of the patients. Clinical presentation of MTBC and MOTT is not always very clear and routine conventional methods are time consuming. Materials and Methods: In the present study, the MPT64 protein detection-based immunochomatographic test (SD Bioline Kit, Standard Diagnostics, Inc., Korea) was compared with the conventional biochemical method. Results: The sensitivity, specificity, positive predictive, and negative predictive values of the SD AgMPT64 kit were found to be 100, 96.4, 98.72, and 100%, respectively. Conclusions: Our results have demonstrated that the SD bioline kit is a rapid, reliable method and it can be used in the Revised National Tuberculosis Control Program (RNTCP) of India, for the appropriate management of tuberculosis. |
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Antimicrobial susceptibility pattern of invasive pneumococcal isolates in North West Nigeria |
p. 70 |
Garba Iliyasu, Abdulrazaq G Habib, Mohammad B Aminu DOI:10.4103/0974-777X.154440 PMID:26069426Background: An alarming increase in infections due to penicillin non-susceptible pneumococci (PNSP) has been documented in nearly all countries. Increasingly, PNSP are also resistant to other antibiotics, and a growing number of clinical failures following the use of these agents have been reported. Aims: To determine the resistance pattern of pneumococcal isolates from patients with invasive pneumococcal infection in North West Nigeria. Materials and Methods: In a cross-sectional study clinical specimens were obtained from patients with community acquired pneumonia (CAP), meningitis and bacteraemia over a 2 year period. Pneumococcus strains were identified. Isolates were tested against a panel of antibiotics using E-test strips, and interpreted according to the CLSI criteria. 0.06 ΅g/ml was used as break point for penicillin. Analysis was carried out using descriptive statistics; relationships determined using chi-squared or Fisher's exact tests, with P < 0.05 regarded as significant. Results: Total number of isolates was 132. Twenty-two (16.7%) of the isolates were fully sensitive to penicillin while 73 (55.3%) and 37 (28.0%) were intermediately and fully resistant, respectively. One hundred and twenty-seven (96.2%) of the isolates were fully resistant to trimethoprim-sulphamethoxazole. Eleven (8.5%) were fully resistant to amoxicillin and 104 (78.8%) and 17 (12.9%) were intermediately resistant and fully susceptible. One hundred and six (80.3%) of the isolates were fully susceptible to chloramphenicol. Resistance to penicillin was shown to infer resistance to other antibiotics. Conclusions: Pneumococcal resistance is common in North West Nigeria. Ceftriaxone retains excellent activity against most of the invasive isolate, while trimethoprim-sulphamethoxazole is almost uniformly resistant. |
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MICROBIOLOGY REPORTS |
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Bacteriological profile of neonatal septicemia in a tertiary care hospital from Western India |
p. 75 |
Vrishali Avinash Muley, Dnyaneshwari Purushottam Ghadage, Arvind Vamanrao Bhore DOI:10.4103/0974-777X.154444 PMID:26069427Neonatal septicemia is an important cause of morbidity and mortality. The present study was undertaken to determine the bacteriological profile and antimicrobial susceptibility pattern of prevalent pathogens isolated from the blood of septicemic neonates from Neonatal Intensive Care Unit (NICU). A total of 180 blood samples of septicemic neonates were studied bacteriologically. Antimicrobial susceptibility testing was done by the Kirby Bauer disc diffusion method in accordance to Clinical Laboratory Standards Institutes (CLSI) guidelines. 26.6% (48 out of 180) cases of septicemia could be confirmed by blood culture. Of these, 66.7% cases were of early onset septicemia (EOS) and 33.3% were of late onset septicemia (LOS). Klebsiella pneumoniae was the predominant pathogen (35.4%) among the Gram-negative pathogens and Staphylococcus aureus (22.9%) was the predominant Gram-positive pathogen. 28% of K. pneumoniae and E. coli isolates were extended spectrum beta-lactamase (ESBL) producers. 18.1% of the Staphylococcus isolates were methicillin-resistant S. aureus (MRSA). Multi-drug-resistance pattern was observed with all the isolates. Ciprofloxacin and aminoglycosides were the most effective drugs against Gram-positive and Gram-negative isolates. This study highlights the predominance of Gram-negative organisms in causing neonatal sepsis and emergence of multi-drug-resistant strains in our set up. |
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Study of antibiotic resistance pattern in methicillin resistant staphylococcus aureus with special reference to newer antibiotic |
p. 78 |
Dardi Charan Kaur, Sadhana Sanjay Chate DOI:10.4103/0974-777X.157245 PMID:26069428The worldwide epidemic of antibiotic resistance is in danger of ending the golden age of antibiotic therapy. Resistance impacts on all areas of medicine, and is making successful empirical therapy much more difficult to achieve. Staphylococcus aureus demonstrates a unique ability to quickly respond to each new antibiotic with the development of a resistance mechanism, starting with penicillin,until the most recent, linezolid and daptomycin. Methicillin resistant S. aureus (MRSA) has become endemic today in hospitals worldwide. Resistance to the newer antimicrobial-agents - linezolid, vancomycin, teicoplanin, and daptomycin are been reported and also the fear of pandrug-resistance. This study was carried out to know the antimicrobial resistant pattern of MRSA to newer antibiotic, to know any isolates are extensively-drug resistant (XDR)/pandrug resistant (PDR), inducible macrolide-lincosamide streptogramin B (iMLSB), and mupirocin resistance. Thirty-six MRSA isolates resistant to the routinely tested antibiotic were further tested for list of antibiotic by a group of international experts. Isolates were tested for iMLSB and mupirocin resistance by the disk diffusion method. Of 385 MRSA, 36 (9.35%) isolates of MRSA were resistant to the routinely tested antibiotic. Among these 36 MRSA isolates, none of our isolates were XDR/PDR or showed resistant to anti-MRSA cephalosporins (ceftaroline), phosphonic acids, glycopeptides, glycylcyclines, and fucidanes. Lower resistance was seen in oxazolidinones (2.78%), streptogramins (5.56%), lipopeptide (5.56%). Thirty-four (94.44%) isolates showed constitutive MLSB (cMLSB) resistance and two (5.56%) iMLSB phenotypes. High- and low-level mupirocin resistance were seen in 13 (36.11%) and six (16.67%), respectively. In our study, none of our isolates were XDR or PDR. No resistance was observed to ceftaroline, telavancin, teicoplanin, and vancomycin; but the presence of linezolid resistance (1, 2.28%) and daptomycin resistance (2, 5.56%) in our rural set-up is a cause of concern. |
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CASE REPORTS |
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A case of aerococcus urinae vertebral osteomyelitis |
p. 85 |
Michael Jerome, Jihad Slim, Raymund Sison, Randy Marton DOI:10.4103/0974-777X.157246 PMID:26069429Aerococcus urinae is an aerobic, alpha hemolytic gram positive coccus bacterium that grows in pairs or clusters. We report the first case of vertebral osteomyelitis due to A. urinae. This has not been previously reported in the literature. |
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Duodenal perforation precipitated by scrub typhus |
p. 87 |
Raghunath Rajat, David Deepu, Arul Jeevan Jonathan, Abhilash Kundavaram Paul Prabhakar DOI:10.4103/0974-777X.154450 PMID:26069430Scrub typhus is an acute febrile illness usually presenting with fever, myalgia, headache, and a pathognomonic eschar. Severe infection may lead to multiple organ failure and death. Gastrointestinal tract involvement in the form of gastric mucosal erosions and ulcerations owing to vasculitis resulting in gastrointestinal bleeding is common. This process may worsen a pre-existent asymptomatic peptic ulcer, causing duodenal perforation, and present as an acute abdomen requiring surgical exploration. We report the case of a patient with no previous symptoms or risk factors for a duodenal ulcer, who presented with an acute duodenal perforation, probably precipitated by scrub typhus infection. |
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LETTERS TO EDITOR |
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DRESS syndrome with peripheral neuropathy due to reactivation of cytomegalovirus in a child |
p. 89 |
Tanigasalam Vasanthan, Ganesan Rajaguru, Chandrasekaran Venkatesh, Parameswaran Narayanan, Reena Gulati, Pampa Ch Toi DOI:10.4103/0974-777X.157249 PMID:26069431 |
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Resident medical officer's knowledge of sepsis: A qualitative study |
p. 90 |
Nata Pratama Hardjo Lugito, Andree Kurniawan, Margaret Merlyn Tjiang, Theo Audi Yanto, Indra Wijaya, Resa Setiadinata, Stevent Sumantri, Euphemia Seto DOI:10.4103/0974-777X.146384 PMID:26069432 |
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Evaluation of a rapid antigen detection test for the diagnosis of group-A beta-hemolytic Streptococcus in pharyngotonsillitis |
p. 91 |
Beula Subashini, Shalini Anandan, Veeraraghavan Balaji DOI:10.4103/0974-777X.154447 PMID:26069433 |
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Chronic osteomyelitis due to streptococcus Suis: First case report from India |
p. 92 |
Dharitri Mohapatra, Gitanjali Sarangi, Priyadarshini Patro, Bimoch P Paty, Nirupma Chayani, Dibya P Mohanty DOI:10.4103/0974-777X.154449 PMID:26069434 |
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Primary septic greater trochanteric bursitis |
p. 93 |
Ellen S Novatnack, Nicole M Protzman, Carl B Weiss DOI:10.4103/0974-777X.154448 PMID:26069435 |
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