A study of rotavirus infection in acute diarrhoea in children less than 5 years of age

: Diarrhoeal diseases account for an estimated 1.5 million deaths globally every year making it the second leading cause of childhood mortality. In India 1 out of every 250 children die of rotavirus diarrhea each year.: To find out the incidence of rotavirus infection in acute diarrhoeal cases in children under 5 years of age.: A prospective study was conducted on 100 non repetetive stool samples of Children under 5 years of age, presenting with acute diarrhea and hospitalized in the pediatric ward, during December 2015 to November 2016. Stool samples were processed according to premier rotaclone enzyme immunoassay protocol for the detection of rotavirus antigen, adhering to standard laboratory precautions.: The incidence of acute diarrhoeal diseases was 5.86% in our setting. was detected in 29% cases by ELISA method.The antigen detection by EIA is a reliable test, as it is quantitative and also has high sensitivity and specificity. Hence, can be routinely employed to prevent major morbidity and mortality among children, especially less than 5 years of age.

Prevalence and the risk factors for the carriage of beta-haemolytic streptococci among women visiting a tertiary care hospital in South India

Streptococci are gram positive cocci arranged in chains and are part of normal flora of humans and animals. The present study is carried out to determine the prevalence and risk factors for the carriage of beta-haemolytic streptococci (BHS) among women visiting Dr. VRK Women’s Teaching Hospital & Research Centre, Hyderabad. Vaginal swabs were collected from 250 patients attending outpatient department (OPD) of Dr. VRK Women’s Teaching hospital. Swabs were inoculated onto 5% sheep blood agar plates and incubated for 24 h at 37°C in a candle jar. BHS isolates were phenotypically identified by standard microbiological techniques, all the isolates presumptively identified as BHS were tested for Bacitracin susceptibility. Sensitive isolates were presumptively identified as GAS and resistant isolates were identified as non-group A BHS (NGABHS). Presumptively identified GAS & NGABHS isolates were serogrouped by Lancefield grouping using a commercially available latex agglutination test. BHS were isolated from 12.4% of samples. As many as 12 BHS isolates were identified as GAS and 19 were identified as NGABHS. Ten of nineteen were identified as group B (GBS), 4 (12.9%) were identified as group C (GCS) and 5 (16.12%) were identified as group G (GGS). Among six clinical groups, the prevalence of GAS is highest i.e. 7.5% in female patients visiting Gynaecology OPD with history of white discharge. Prevalence of NGABHS was more among post insertion (18%) IUCD group compared to pre insertion (8%) IUCD group. GBS were isolated from 7% of samples from IUCD group and 4% of samples from prostitutes.This study reports the prevalence of BHS among women visiting a tertiary care hospital in Hyderabad. This study also identified certain risk factors such as IUCD usage and working as a FSW are associated with the increased prevalence of NGABHS especially GBS.

Comparative study of manual conventional blood cultures versus automated blood culture system in cases of septicemia

: Blood cultures are a proven gold standard method for the identification of causative agents of bloodstream infections. Identification of causative organism along with antibiotic susceptibility plays a pivotal role in proposing suitable antibiotic therapy. Automated blood culture systems show improved monitoring of blood cultures by reducing the time and by ensuring more accurate results when compared to the conventional blood culture system. To isolate the organism from given blood samples of a suspected case of septicemia and to compare the results of conventional and automated blood culture systems and to study the antimicrobial susceptibility pattern of the pathogens isolated. A prospective study of 6 months period was conducted among 100 subjects attending the Department of Microbiology in a tertiary care hospital. Subjects with symptoms and signs of septicemia were included. 25ml of venous blood was drawn aseptically from the venipuncture site, of which 5ml of blood was inoculated into 50ml of Brain Heart Infusion bottle in conventional blood culture system and 10ml each into aerobic and anaerobic BACTEC PLUS bottle in Automated blood culture system BACTEC FX40. Overall, 48% and 60% of the samples revealed positive growth by the conventional and automated blood culture system BACTEC FX40, respectively. Gram Positive Cocci were 52.08% and Gram Negative Bacilli were 47.91% isolated by conventional blood culture system, whereas automated blood culture system BACTEC FX40 isolated 45% and 55%, respectively. Isolates were detected within 24-48hrs and 12-24 hrs by conventional and automated blood culture systems, respectively. The anti-microbial susceptibility pattern of the pathogens isolated was also recorded by Kirby Bauer disc diffusion method of antimicrobial susceptiblity testing. Automated blood culture systems are a trustworthy substitute to conventional blood culture systems. The automated blood culture systems being more sensitive and rapid in detecting septicemia in subjects acts as an appropriate means for the initial identification and detection of blood pathogens and improved provision of antimicrobial therapeutic options for septic Patients especially in Critical Care and Intensive Care Units where positive culture reporting is crucial.

Comparison between ziehl-neelsen staining and fluorescent staining of sputum samples to detect acid fast bacilli in suspected case of pulmonary tuberculosis at tertiary care hospital, Amreli, Gujarat

In India, Tuberculosis (TB) is one of the major community health problems.Pulmonary tuberculosis (PTB) is a respiratory disease. Causative organism for this is acid fast bacilli known as . It is the most ordinary disease affecting the lower socio-economic class in developing countries. Microbiological diagnosis is the heart for the effective treatment of pulmonary TB (PTB). The look forrapid and efficient method has resulted in several staining techniques. Objective of the study was to compare the results of ZN stain (RNTCP) with fluorescent stain by use of microscopy. The study was carried out in Microbiology Department, SMCGH, Amreli. 350 sputum samples (Spot and early morning sample) collected from 175 suspected case of the pulmonary tuberculosis. All 350 samples were processed by ZN stain and Fluorescent stain to detect acid fast bacilli. By use of microscope, the results of the stained smears were given according to RNTCP guideline.Out of 350 sputum smears, 52 (14.85%) and 61 (17.4%) were positive by ZN and FM staining respectively. Males are predominantly affected than females. Majority of the patients were in age above 50 years. Early morning samples were more reliable than spot samples for detection of acid fast bacilli for ZN stain, but not for fluorescent stain.Fluorescent staining with LED microscopy was more efficient than ZN staining for detection of acid fast bacilli from sputum smear.

Occurrence of carbapenem-resistant organisms in gastrointestinal postoperative infections: A therapeutic challenge

Dissemination of multidrug resistant organisms including Carbapenem-Resistant Organisms (CRO) in Hospitals is of global concern. Such nosocomial infections are more common during surgical procedures involving prolonged post-operative care and Hospital stay. Treatment options include administration of prophylactic antibiotics, which are broad-spectrum antibiotics. However, long-term administration of these antibiotics leads to an increase in the incidence of multidrug resistant organisms in Hospital sectors. To evaluate early detection of carbapenemase producing organisms from the clinical isolates of postoperative patients by carba NP test. The study was conducted at the diagnostic laboratory in clinical samples obtained from hospitalized patients. A total of 716 clinical samples were tested by employing basic microbiological and biochemical testing methods and the isolates were screened for antimicrobial susceptibility. Carbapenem-resistant isolates were then confirmed by E-test (imipenem, meropenem) and also via carba NP test.In a total of 716 samples, 257 tested positive for various microorganisms, of which 230 gram-negative bacilli were identified. Amongst them, 93 isolates were identified as resistant to carbapenem by disc diffusion method of which 50 isolates were tested for carbapenemase production. Within the 50 isolates, 47 isolates were resistant to E-test meropenem and 40 isolates were resistant to imipenem. Of note, 35 out of the 50 CROs were identified as carbapenemase producers. Our results show that Carba NP test is a simple method that can be employed routinely for early detection of carbapenemase mediated CROs thus reducing the spread of resistant strains in Hospitals.

A study on susceptibility patterns, resistance mechanisms and cross- resistances of antibiotics against Pseudomonas aeruginosa in a teaching hospital at Puducherry

, a gram negative bacteria causes lung and nosocomial infections, mostly infect the body after surgery or invasive techniques. There has been a increasing prevalence in drug resistant variants in the recent years. 1. To determine the antibiotic susceptibility patterns of ; 2. To assess the antibiotics used against and the cross-resistence pattern existing between them; 3. To evaluate the possible resistance mechanisms of by phenotypic techniques.Thirty six consecutive, nonduplicate isolates were collected between January to July in the year 2018 from the hospital pus samples. The isolates showed synthesis of pyocyanin and a oxidase positive reaction. Kirby bauer’s disc diffusion method (HIMEDIA). was used for assessing the sensitivity of drugs. Disk approximation test was done to check the prevalence of inducible β-lactamases. Modified Hodge test was done to assess the metallo-β-lactamase activity. Double disk synergy method had been preferred to evaluate the extended-spectrum beta-lactamase (ESBL) activity. The most sensitive antibiotic was found to be ciprofloxacin which is followed by amikacin and ceftazidime (p < 0.05). 36% of the samples were resistant to more than one antibiotic groups. Cross-resistance was observed between the antibiotics. 53% of the samples had Inducible β-lactamases. Eighty percent of the samples which were non-resistant to ceftazidime showed positive reaction for inducible beta-lactamase. 2% isolates by DDS method showed the presence of ESBLs. The study samples did not show the presence of Metallo-β-lactamases.Strict adherence to the recent trend of “reserve drugs” concept and minimizing the misuse of antibiotics can bring down the drug resistance and morbidity. The addressal of irrational and inappropriate use of antimicrobials among the clinician is the need of the hour.

C-reactive protein as a diagnostic marker of neonatal sepsis in association with blood culture a retrospective study at a tertiary care hospital

To evaluate the sensitivity and specificity of C-Reactive protein as a single diagnostic inflammatory biomarker of neonatal sepsis in association with the blood culture.In this study, we retrospectively reviewed the medical records of 330 neonates at a tertiary care hospital at Gurugram from Jan, 2015 to Dec, 2020. The study population included neonates <1month age. Neonates meeting the IPSC criteria (Sepsis 2.0)1 and with a positive culture were considered as neonates with proven sepsis. Neonates with congenital malformations and congenital infections associated with TORCH complex were excluded from the study.Of the 330 neonates screened for sepsis, 32 (10%) had a positive blood culture with raised CRP in 69 (21%) cases. Among the 32 cases with positive blood culture, CRP identified 29 cases. The sensitivity, specificity, positive predictive value, negative predictive values of CRP were 90.6%, 86.5%, 42% and 99% respectively. The area under the curve (AUC) for the CRP ROC analysis was 0.83 with sensitivity of 90.6% and specificity of 91.6% which showed CRP usefulness as the diagnostic inflammatory biomarker of neonatal sepsis.Prematurity (53%) in neonates was the most common risk factor associated with neonatal sepsis. Klebsiella pneumoniae 11 (34%) was the most common pathogen isolated with 73% susceptibility to Ciprofloxacin.C-Reactive protein was found to have a high diagnostic value in terms of sensitivity of 90.6% and specificity of 91.6% when 0.83 is used as a cut off point for diagnosis of neonatal sepsis. Therefore, CRP could be used as diagnostic inflammatory biomarker in resource poor settings.

A study of biofilm production and antimicrobial susceptibility pattern among urinary isolates

Urinary tract infection (UTI) is the most commonly acquired bacterial infection. Bacterial biofilms play an important role in urinary tract infections and are responsible for persistent infections as well as higher antimicrobial resistance. The microbial biofilms pose a public health problem as the microorganisms in the biofilms are difficult to treat with antimicrobial agents. So the present study was undertaken with the aim to study biofilm production and antimicrobial susceptibility pattern of urinary isolates. Aerobic bacterial isolates from urine samples submitted to microbiology laboratory for culture were included in the study. The isolates were tested for biofilm formation by Congo red agar method and Christensen tube method. Antimicrobial susceptibility tests were performed on these isolates by Kirby Bauer disk diffusion method as per CLSI guidelines. A total of 293 Gram negative bacilli and 59 Gram positive cocci were tested for biofilm production and antimicrobial susceptibility testing. : Gram‑negative organisms were predominant (83.24%) of all the isolates. Biofilm production was detected in 47% of the isolates. 51.7%), were the most common biofilm producing Gram negative bacilli followed by (44.32%). Amongst Gram positive cocci, (77.8%) was the most common biofilm producing organism. Biofilm producing urinary isolates displayed relatively less percentage of antimicrobial susceptibility than biofilm non producers. Biofilm forming isolates showed higher antimicrobial resistance as compared to biofilm non producer. Early detection of biofilm production in urinary isolates may aid clinicians in treatment of urinary tract infections.

Spectrum of dermatophytes in a tertiary care centre in Northern India

Dermatophytes is major public health challenge in many parts of the world, mainly in developing countries due to poor housing facilities, high population per capita, and poor sanitary conditions. Early diagnosis and identification is must for preventing and early treatment of dermatophytosis. Also, some studies suggest that in prepubescent children there is an inadequate amount of fungi inhibiting fatty acids synthesized predisposing them to dermatophytic infections. Reduction in the synthesis of these fungistatic triglycerides in sebum premenopausal women is also seen predisposing them to infection by dermatophytes. However, low socioeconomic status along with illiteracy and overpopulation has been a main predisposing factor to dermatophytic infections in developing parts of the world. The incidence also been increased due to the rise in the number of immunocompromised patients and considerable use of broad-spectrum antibioticsEarly finding of infection is must for prevention and early management of dermatophytosis. Dermatophytes enter keratinized tissue via keratinases, which produce a dermal inflammatory response causing burning, itching and rednessTo determine prevalence of species of dermatophytes. This Study was conducted on 334 samples i.e. skin scrapings, nail clippings, and hair for fungal culture in the Mycology laboratory over a period of one year extending from December 2019 to December 2020. Specimens were cultured on modified Sabouraud's dextrose agar media containing antibiotics and incubated at 25°C and 37°C for a period of 4 weeks. Isolation and identification of various species of dermatophytes were done. A cross-sectional study was conducted on patients who came to our hospital in the department of dermatology or were referred to the department of microbiology over a period of one year extending from November 2019 to November 2020. Microbiological tests of suspected patients included potassium hydroxide (KOH) mount and fungal culture examination. Cases with culture-positive results were correlated with clinical diagnosis. In the study total of 334 samples (skin scrapings, nail clippings, and hair) were received for fungal culture in the microbiology laboratory during the study period. Samples obtained were cultured on modified Sabouraud's dextrose agar (SDA) media containing antibiotics and incubated at 25°C and 37°C for a period of 4 weeks. Species identification was performed based on colony's morphology, finding of the teased mount by using lactophenol cotton blue stain (LCB) and slide culture, and also with urea hydrolysis test as seen.The Study was performed on 334 samples received from the department of dermatology for fungal culture. Fungal elements were seen in 31% of cases and were isolated in 30% of cases. In these culture-positive cases, dermatophytes were reported in 90% cases, Candida species in 4%, and another fungus was reported in 6% cases. Trichophyton species is most commonly isolated (27.6%). Microsporum and Epidermophyton species were isolated in 5.1% cases. T. mentagrophytes was the most common fungal isolate among all the culture-positive cases.

Desmoplastic ameloblastoma in maxilla mimicking fibro-osseous leison: A case report

Desmoplastic Ameloblastoma accounts for 4% to 13% of all ameloblastomas and is a rare variant with high rate of recurrence. The desmoplastic variant of ameloblastoma usually appears in the anterior and premolar regions and sometimes resembles a benign fibro-osseous lesion showing a mixed radiolucent and radiopacity in the radiographic examination. Malignant transformation with repeated postsurgical recurrences have also been reported. In this paper we present a case of a 22-year-old female with swelling in the left upper jaw which turned out to be desmoplastic ameloblastoma. The pathologist and the clinician should be aware of the concepts and the association with malignant transformation and spread of the lesion in order to deliver appropriate treatment and to avoid further recurrences of the leison.