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   2015| April-June  | Volume 7 | Issue 2  
    Online since May 19, 2015

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Study of antibiotic resistance pattern in methicillin resistant staphylococcus aureus with special reference to newer antibiotic
Dardi Charan Kaur, Sadhana Sanjay Chate
April-June 2015, 7(2):78-84
DOI:10.4103/0974-777X.157245  PMID:26069428
The 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.
  6,481 111 -
Utility of MPT64 antigen detection for rapid confirmation of mycobacterium tuberculosis complex
Jyoti Arora, Gavish Kumar, Ajoy Kumar Verma, Manpreet Bhalla, Rohit Sarin, Vithal Prasad Myneedu
April-June 2015, 7(2):66-69
DOI:10.4103/0974-777X.154443  PMID:26069425
Background: 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.
  4,856 35 -
Bacteriological profile of neonatal septicemia in a tertiary care hospital from Western India
Vrishali Avinash Muley, Dnyaneshwari Purushottam Ghadage, Arvind Vamanrao Bhore
April-June 2015, 7(2):75-77
DOI:10.4103/0974-777X.154444  PMID:26069427
Neonatal 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.
  4,606 38 -
2015 resurgence of influenza a (H1N1) 09: Smoldering pandemic in India?
Baijayantimala Mishra
April-June 2015, 7(2):56-59
DOI:10.4103/0974-777X.157236  PMID:26069423
  4,137 23 -
Utility of line probe assay for the early detection of multidrug-resistant pulmonary tuberculosis
K Madhuri, Smita Deshpande, Sujata Dharmashale, Renu Bharadwaj
April-June 2015, 7(2):60-65
DOI:10.4103/0974-777X.157237  PMID:26069424
Background: 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.
  3,932 26 -
Antimicrobial susceptibility pattern of invasive pneumococcal isolates in North West Nigeria
Garba Iliyasu, Abdulrazaq G Habib, Mohammad B Aminu
April-June 2015, 7(2):70-74
DOI:10.4103/0974-777X.154440  PMID:26069426
Background: 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.
  3,777 33 -
Evaluation of a rapid antigen detection test for the diagnosis of group-A beta-hemolytic Streptococcus in pharyngotonsillitis
Beula Subashini, Shalini Anandan, Veeraraghavan Balaji
April-June 2015, 7(2):91-92
DOI:10.4103/0974-777X.154447  PMID:26069433
  3,594 26 -
Duodenal perforation precipitated by scrub typhus
Raghunath Rajat, David Deepu, Arul Jeevan Jonathan, Abhilash Kundavaram Paul Prabhakar
April-June 2015, 7(2):87-88
DOI:10.4103/0974-777X.154450  PMID:26069430
Scrub 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.
  3,430 35 -
Resident medical officer's knowledge of sepsis: A qualitative study
Nata Pratama Hardjo Lugito, Andree Kurniawan, Margaret Merlyn Tjiang, Theo Audi Yanto, Indra Wijaya, Resa Setiadinata, Stevent Sumantri, Euphemia Seto
April-June 2015, 7(2):90-91
DOI:10.4103/0974-777X.146384  PMID:26069432
  3,423 34 -
Primary septic greater trochanteric bursitis
Ellen S Novatnack, Nicole M Protzman, Carl B Weiss
April-June 2015, 7(2):93-94
DOI:10.4103/0974-777X.154448  PMID:26069435
  3,253 25 -
Chronic osteomyelitis due to streptococcus Suis: First case report from India
Dharitri Mohapatra, Gitanjali Sarangi, Priyadarshini Patro, Bimoch P Paty, Nirupma Chayani, Dibya P Mohanty
April-June 2015, 7(2):92-93
DOI:10.4103/0974-777X.154449  PMID:26069434
  3,191 26 -
State of the globe: Ebola outbreak in the western world: Are we really ready?
Miguel Reina-Ortiz, Ismael Hoare, Vinita Sharma, Ricardo Izurieta
April-June 2015, 7(2):53-55
DOI:10.4103/0974-777X.157235  PMID:26069422
  3,021 18 -
A case of aerococcus urinae vertebral osteomyelitis
Michael Jerome, Jihad Slim, Raymund Sison, Randy Marton
April-June 2015, 7(2):85-86
DOI:10.4103/0974-777X.157246  PMID:26069429
Aerococcus 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.
  2,937 18 -
DRESS syndrome with peripheral neuropathy due to reactivation of cytomegalovirus in a child
Tanigasalam Vasanthan, Ganesan Rajaguru, Chandrasekaran Venkatesh, Parameswaran Narayanan, Reena Gulati, Pampa Ch Toi
April-June 2015, 7(2):89-90
DOI:10.4103/0974-777X.157249  PMID:26069431
  2,825 23 -
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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008