Journal of global infectious diseases (J Glob Infect Dis)

Publisher: Medknow Publications

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ISSN 0974-8245

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Medknow Publications

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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Staphylococcus aureus (S. aureus) causes a variety of infections, ranging from a mild skin infection to blood stream infections and deep seated infections. As Stapylococcus aureus bacteremia (SAB) has the tendency to cause endovascular and metastatic infections, complications can occur at almost all sites of the body. Hence, SAB is associated with increased morbidity and mortality in spite of appropriate antimicrobial treatment. The virulence in S. aureus is determined by the presence of adhesins and toxins, which behave like superantigens (SAgs) and leads to a massive release of proinflammatory cytokines causing overwhelming inflammatory response leading to endothelial leakage, hemodynamic shock, multiorgan failure, and possibly death. Materials and Methods: One year prospective study conducted in a tertiary care hospital in southern part of India included all patients with SAB. Clinical details were filled according to. All isolates were subjected to polymerase chain reaction (PCR) for enterotoxin profiling. Results: A total of 101 patients of SAB were identified which comprises of 61 (60.4%) patients with methicillin-susceptible S. aureus (MSSA) and 40 (39.6%) patients with methicillin-resistant S. aureus (MRSA). Most common predictors of mortality were prior hospitalization and antibiotic intake, severe organ dysfunction, shock, tachycardia, and leukocytosis. Two-third of the isolates had at least one enterotoxin, most prevalent was sea; 28% and 27% (P - value = 0.001) MSSA isolates had seg and sei; whereas, 38.6% (P - value < 0.001) of MRSA isolates were found to have sea. The most common enterotoxin associated with mortality was sei, which comprised of 38% of all mortality. Conclusion: In SAB, the significant predictors of mortality were prior hospitalization and antibiotic intake, presence of multiorgan dysfunction, and shock. Although overall significance between the enterotoxin and shock could not be demonstrated, it successfully demonstrated the difference of enterotoxin between MSSA and MRSA.
    Journal of global infectious diseases 09/2015; 8(1):1-6. DOI:10.4103/0974-777X.162234
  • Journal of global infectious diseases 02/2015; 7(1):46-7. DOI:10.4103/0974-777X.150892
  • Journal of global infectious diseases 02/2015; DOI:10.4103/0974-777X.150890
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    ABSTRACT: A retrospective analysis was done over a period of 3 years (January 2010- December 2012) in a tertiary care hospital, Pune, to note the changes in the prevalence and distribution of biotypes, serotypes, antibiotic susceptibility pattern and phage types of Vibrio cholerae isolates from clinical samples so as to be vigilant and curtail major outbreak in future. Vibrio cholerae isolates were obtained from 4.4% of the 1126 fecal specimens processed from cases of acute watery diarrhea. Majority of the isolates were identified as V. cholerae O1 biotype El Tor serotype Ogawa (98%); Phage 27 was the predominant type (77.5%). Majority of the cases were encountered during the months June-August (68%). Antibiogram over a period of 3 years showed that isolates were consistently resistant to Ampicillin (90%) and Furazolidone (88%). Low level of resistance was seen with Norfl oxacin (8%), Gentamicin (8%) and Tetracycline (6%). All isolates were susceptible to Chloramphenicol.
    Journal of global infectious diseases 01/2015; 7(1):34-36. DOI:10.4103/0974-777X.146375
  • Journal of global infectious diseases 01/2015; 7:11-17.
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    ABSTRACT: The aim of study was to find out the potential pathogenic role of virulence factors elaborated by strains of vancomycin resistant enterococci (VRE) isolated from clinical samples and VRE colonizing the gastrointestinal tract of hospitalized patients. Enterococci were isolated from various clinical samples and also from fecal specimens of colonized patients at the time of admission, after 48 h and after 5 days of admission. Various virulence determinants were detected by phenotypic tests. Vancomycin susceptibility in enterococci was detected by disc diffusion and agar screen method. Minimum inhibitory concentration was determined by agar dilution method. Out of all the clinical and fecal samples processed, 12.0% isolates were either vancomycin resistant or vancomycin intermediate. Hemagglutinating activity against rabbit red blood cells was seen with 27.8% and 25.0% of clinical and fecal strains, respectively. Slime layer formation was seen with fecal VRE strains (37.5%) when compared to clinical VRE (27.8%). Among the clinical VRE strains the most prolific biofilm producers were Enterococcus. fecalis (92.9%) when compared to Enterococcus. faecium (52.9%). Biofilm formation/(presence of adhesions) was also seen in (29.2%) of the fecal VREs. In wound infection production of gelatinase, deoxyribonuclease (DNase), and caseinase (70.0% each) were the major virulence factors. The predominant virulence factors seen in the blood stream infection were adhesin, and hemolysin (44.4% each) and in catheter induced infection were DNase and adhesins (75.0% each). Adhesin (29.2%), slime layer (37.6%), DNAse (33.3%), gelatinase (25.0%), lipase (20.8%) and caseinase (16.6%) and hemolysin (8.3%) were produced the fecal isolates. An association between adhesin (as detected by biofilm formation) and urinary tract infection, adhesion and hemolysin with BSI, as also between DNase gelatinase & caseinase with wound infection was noted.
    Journal of global infectious diseases 10/2014; 6(4):157-63. DOI:10.4103/0974-777X.145242
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    ABSTRACT: Tuberculosis (TB) remains a serious public health problem worldwide. The emergence of drug resistance and multidrug resistance (MDR) has become the main threat to TB treatment and control programs. Rapid detection is critical for the effective treatment of patients. In recent times, a new method using the colorimetric indicator resazurin has been proposed for drug susceptibility of Mycobacterium tuberculosis. In this study, the resazurin reduction assay was adapted to screw cap tubes. Using the Resazurin Tube Method (RTM), a total of 100 clinical isolates were tested against Rifampicin (RIF) and Isoniazide (INH). By visual reading, the minimum inhibitory concentrations (MICs) were obtained after eight days. The results obtained were compared with the gold standard proportion method. Excellent results were obtained for RTM with a sensitivity of 100% for both RIF and INH, with a specificity of 98.7 and 95.3%, respectively. Kappa is the measure of agreement between the RTM and proportion method (PM) for RIF and INH, which was found to be 0.972 and 0.935 for RIF and INH, respectively. The RTM appears to be a reliable method for the rapid and simultaneous detection of MDR-TB and drug susceptibility testing (DST) of M. tuberculosis. It is simple, inexpensive, and with no biohazard risk involved.
    Journal of global infectious diseases 10/2014; 6(4):151-6. DOI:10.4103/0974-777X.145239
  • Journal of global infectious diseases 10/2014; 6(4):195-6. DOI:10.4103/0974-777X.145260
  • Journal of global infectious diseases 10/2014; 6(4):194-5. DOI:10.4103/0974-777X.145256
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    ABSTRACT: Dealing with severe blood stream infections (BSI) is one of the intractable conditions in hospitals. The empirical treatment given remains pertinent in determining patient outcome, which becomes evidence based when substantiated by knowledge of susceptibility patterns of prevalent pathogenic organisms in the set up. This study was undertaken to determine the occurrence, species prevalence, and antibiotic susceptibility pattern of laboratory confirmed BSI (LCBSI) in patients admitted to our multi-specialty sanatorium. Eight hundred and forty-six blood samples from 829 patients suspected of having BSI were cultured as per standard microbiological procedures. Antimicrobial susceptibility testing was done for bacterial isolates from positive blood cultures. Sixty (7.2%) cases were established as LCBSI. A total of eight pathogenic bacterial genera were identified and their antimicrobial susceptibility pattern was noted. Staphylococcus spp. were most prevalent (33%), followed by Klebsiella pneumoniae (20%), Escherichia coli (13%), Acinetobacter spp. (13%), Enterococcus spp. (12%), Pseudomonas aeruginosa (3%), Proteus spp. (2%), and Citrobacter spp. (2%). The study shows the prevalence of common bacterial pathogens causing BSI and their susceptibility patterns. Such studies provide benefit of instantaneous choice of antibiotic therapy aiming at improved patient management and reduced drug resistance.
    Journal of global infectious diseases 10/2014; 6(4):141-6. DOI:10.4103/0974-777X.145231
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    ABSTRACT: Drug resistance to Pseudomonas sp. has spread to such a level irrespective of the type of patients, that its pattern of distribution and antibiotic resistance needs to be studied in detail, especially in trauma patients and hence the study. A 6 year study was carried out among trauma patients to see the trend and type of resistance prevalent in the apex hospital for trauma care in India among nonduplicate isolates where multidrug-resistance (MDR), cross-resistance and pan-drug resistance in Pseudomonas sp. were analyzed. Of the total 2,269 isolates obtained, the species, which was maximally isolated was Pseudomonas aeruginosa (2,224, 98%). The highest level of resistance was seen in tetracycline (2,166, 95.5%, P < 0.001) and chloramphenicol (2,160, 95.2%, P < 0.001) and least in meropenem (1,739, 76.7%, P < 0.003). Of the total, 1,692 (74.6%) isolates were MDR in which P. aeruginosa (75%) were maximum. MDR Pseudomonas is slowing increasing since the beginning of the study period. Of 1,797 imipenem-resistant P. aeruginosa isolated during the study period, 1,763 (98%) showed resistance to ciprofloxacin or levofloxacin, suggesting that cross-resistance may have developed for imipenem due to prior use of fluoroquinolones. Antibiotic resistance in Pseudomonas sp. is fast becoming a problem in trauma patients, especially in those who requires prolong hospital stay, which calls for proper antimicrobial stewardship.
    Journal of global infectious diseases 10/2014; 6(4):182-5. DOI:10.4103/0974-777X.145250
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    ABSTRACT: Periorbital soft tissue swelling may result due to primary orbital pathology or from adjacent facio-maxillary or sino-nasal inflammatory causes. Osteomyelitis of maxilla in the pediatric age group is a rare entity in this era of antibiotics. We present an 11-month-old female infant who was brought with peri-orbital selling and purulent nasal discharge. Computed Tomography showed erosions of the walls of maxillary sinus suggestive of osteomyelitis. Culture of sinus scraping showed Staphylococcus aureus growth and the child improved with intravenous cloxacillin therapy. This case is presented due to the rarity of its presentation in this age group and for awareness to consider this entity in children having fever and peri-orbital swelling.
    Journal of global infectious diseases 07/2014; 6(3):125-7. DOI:10.4103/0974-777X.138511
  • Journal of global infectious diseases 07/2014; 6(3):135-6. DOI:10.4103/0974-777X.138515
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    ABSTRACT: Background and Objectives: There is a paucity of information available on acute respiratory infection (ARI) among school children in India. This study was aimed to assess the prevalence and certain risk factors associated with ARI among school children. Materials and Methods: This cross-sectional study was conducted among 397 school children age group of 5-14 years in the seven schools of rural Puducherry, India. Data on socio-demographic characteristics and associated risk factors of ARI were collected by interview using pre-tested structured questionnaire. Data was analyzed by univariate and multiple logistic regression analysis. Results: Overall, 51.1% (203) of the subjects had at least one symptom of ARI in the preceding 2 weeks. The manifestations of ARI included allergic rhinitis (183, 46.1%), dry cough (75, 18.9%), throat pain and fever (54, 13.6%), wheezing (39, 9.8%) and ear discharge (28, 7.1%). About half of the subjects with ARI (52.2%) belonged to 5-9 year age group and females (52.3%). Mother's education, family history of allergic disorder and asthma, absence of smoke outlet in kitchen and windows in sleeping room were found to be significantly associated with ARI in univariate analysis (P < 0.05). Multiple logistic regression analysis showed that 5-9 years age group (odds ratio [OR] = 1.7), family history of allergic disorder (OR = 9.6) and asthma (OR = 5.2), presence of smoke outlet in kitchen (OR = 0.5), absence of windows in sleeping room (OR = 3.0) were found to have an independent association with the ARI. About 29.6% (60) of the subjects with ARI had accessed health care facility for treatment. Conclusion: ARI among school children is an important health problem. Interventions like provision of smoke outlets and windows in sleeping room may help in reduction of burden of ARI.
    Journal of global infectious diseases 07/2014; 6(3):95-8. DOI:10.4103/0974-777X.138498