C. Rodrigues's research while affiliated with P.D Hinduja National Hospital & Medical Research Centre and other places
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Publications (97)
Introduction/Objective
Sepsis is a global health priority and is often accompanied by a transient immune paralysis, associated with impairment in innate and adaptive immunity leading to progressive immunosuppression and higher susceptibility to secondary infections. Reactivation of Cytomegalovirus (CMV) occurs frequently and has been associated wit...
Background:
We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific.
Methods:
During the 6-year study period, prospective da...
OBJECTIVE To conduct a multicentre study to establish the critical concentration (CC) for clofazimine (CFZ) for drug susceptibility testing (DST) of Mycobacterium tuberculosis on the MGIT™960™ system using the distribution of minimum inhibitory concentrations (MIC) and genotypic analyses of Rv0678 mutations. DESIGN In phase I of the study, the MIC...
BACKGROUND The World Health Organization recommends drug-susceptibility testing of Mycobacterium tuberculosis complex for all patients with tuberculosis to guide treatment decisions and improve outcomes. Whether DNA sequencing can be used to accurately predict profiles of susceptibility to first-line antituberculosis drugs has not been clear. METHO...
Timely diagnosis of tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), is only achieved for ~58% cases. An improved, accurate, time- and cost-effective method for bacteriological confirmation of MTB is necessary. We evaluated Mycotube, a new variant of Lowenstein–Jensen (LJ) culture medium, by comparing it with Mycobacterium Growth Indi...
Molecular diagnostics, with their ability to rapidly detect resistance-associated mutations in bacterial genes, are promising
technologies to control the spread of drug-resistant tuberculosis (DR-TB). Sequencing assays provide detailed information
for specific gene regions and can help diagnostic developers prioritize mutations for inclusion in the...
Non-tuberculous mycobacteria (NTM)—previously considered as saprophytic organisms—are now increasingly recognized as human pathogens [1, 2]. Although humans are routinely exposed to NTM, clinical infection rates are low; further, these infections typically occur in immunocompromised patients. However, an increasing incidence of NTM infections in im...
To develop and evaluate rapid, molecular-based drug susceptibility testing (DST) for extensively drug-resistant tuberculosis (XDR-TB), we assembled a phenotypically and genotypically diverse collection of Mycobacterium tuberculosis isolates from patients evaluated for drug resistance in four high-burden countries.
M. tuberculosis isolates from Indi...
We read with interest the correspondence regarding “Acid-fast bacilli: culture positivity and drug resistance in abdominal tuberculosis”. It is well known that breakthrough contamination occurs in TB Mycobacteria Growth Indicator Tube (MGIT) cultures up to 8.1 %; this is even higher for all combined solid media at 21 %. At our CAP- and NABL-accredi...
Background
By using whole genome sequencing (WGS), researchers are beginning to understand the genetic diversity of Mycobacterium tuberculosis (MTB) and its consequences for the diagnosis of multidrug-resistant tuberculosis (MDR–TB) on a genomic scale. The Global Consortium for Drug-resistant TB Diagnostics (GCDD) conducted a genome scale variant a...
We report five patients with infective endocarditis (IE) due to rapidly growing mycobacteria (RGM) which we postulate are related to the reuse of percutaneous transluminal angioplasty balloon catheters prior to the intravascular stent placement. The index procedure was performed at various institutes in different parts of the country. We call atten...
Carbapenem-hydrolyzing β-lactamases are increasingly reported worldwide, leading to therapeutic failure. In an era where the drug development pipeline is stagnant, it is crucial to preserve current classes of antibiotics to help fight against infection caused by multidrug-resistant organisms (MDROs), by practicing a rational approach for the use of...
To establish breakpoint concentrations for the fluoroquinolones (moxifloxacin [MFX] and ofloxacin [OFX]) and injectable second-line drugs (amikacin [AMK], kanamycin [KM] and capreomycin [CPM]) using the microscopic observation drug susceptibility (MODS) assay.
A multinational study conducted between February 2011 and August 2012 in Peru, India, Mol...
The American Society for Microbiology (ASM) and the Journal of Clinical Microbiology (JCM) are issuing this Expression of Concern to alert readers to questions about the ownership of the data in the following publication: M. Hoshide, L. Qian, C. Rodrigues, R. Warren, T. Victor, H. B. Evasco II, T. Tupasi, V. Crudu, and J. T. Douglas. Geographic Dif...
Central-line associated blood stream infection (CLABSIs)is associated with increase hospital costs and length of stay. Antibiotic lock therapy (ALT) along with systemic antibiotics appears to be an option for catheter salvage. Most studies on ALT have focused on Coagulase-negative staphylococcal (CoNS) infections. However, CLABSIs due to extended s...
SUMMARY We report on the effect of the International Nosocomial Infection Control Consortium's (INICC) multidimensional approach for the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 21 intensive-care units (ICUs), from 14 hospitals in 10 Indian cities. A quasi-experimental study was conducted, which was divid...
SETTING: A tertiary care centre in Mumbai, India.OBJECTIVE: To estimate the extent of association between inhA mutant isoniazid (INH) resistant strains and ethionamide (ETH) resistance.DESIGN: A total of 140 clinical isolates processed for INH and ETH phenotypic drug susceptibility testing, and molecularly processed with the line-probe assay (LPA)...
A tertiary care centre in Mumbai with a referral bias towards treatment failures.
To standardise and evaluate a novel single tube multiplex nested polymerase chain reaction (PCR) targeting insertion sequence (IS) 6110, mpb64, rrs and rpoB genes for rapid diagnosis of extra-pulmonary tuberculosis (EPTB).
The PCR assay was evaluated among 489 consecu...
An early initiation of antifungal therapy in invasive fungal infections (IFIs) is critical in reducing the high mortality rate. Current diagnosis of fungal infection relies on microscopy, culture, antigen, antibody specific tests and histological diagnosis. However, these tests either lack sensitivity or specificity. There is thus the need for a ra...
To evaluate fluorescence microscopy (FM) using light emitting diode (LED) technology for the detection of acid-fast bacilli at a tertiary referral centre in Mumbai, India, a tuberculosis-endemic country.
LED FM was introduced into a laboratory experienced with Ziehl-Neelsen (ZN) microscopy but unfamiliar with FM. It was evaluated in parallel with r...
To identify and characterise disease caused by non-tuberculous mycobacteria (NTM) in a tuberculosis-endemic region.
A total of 133 NTM isolates cultivated using Mycobacteria Growth Indicator Tube 960 (MGIT 960) plus Löwenstein-Jensen (LJ) and identified using the NAP and PNBA tests were screened to species level using molecular methods. The 360-bas...
To evaluate the performance of an automated BACTEC MGIT 960, a non-radioactive, non-invasive liquid culture system for cultivation of M. tuberculosis complex in terms of recovery rate and time.
From March 2005 to December 2007, 14,597 specimens were processed using the MGIT 960 system and the results were compared with conventional L.J medium. We s...
Unrecognized cross-contamination has been known to occur in laboratories frequently, especially with sensitive recovery system like BACTEC 460 TB. In March 2001, we investigated a pseudo-outbreak of Mycobacterium tuberculosis isolates in three smear negative clinical specimens and would like to present our experience in this communication. Methods...
To establish the critical test concentrations for seven second-line anti-tuberculosis drugs in the Bactec Mycobacterial Growth Indicator Tube (MGIT) 960 TB system and to evaluate its efficacy compared to the Bactec 460 TB system.
This study was carried out in three phases. In Phase I, pan-susceptible strains were tested to establish the minimum inh...
Enteric fever is endemic in Mumbai and its diagnosis poses several problems. Our main aim was to study the clinical profile, haematological features of culture proven typhoid cases, the antimicrobial susceptibility pattern of the isolates and the time to defervescence with the treatment received.
This was a retospective chart review of all cases of...
We sought to determine the rate of healthcare-associated infection (HCAI), microbiological profile, bacterial resistance, length of stay (LOS) and excess mortality in 12 ICUs of the seven hospital members of the International Infection Control Consortium (INICC) of seven Indian cities. Prospective surveillance was introduced from July 2004 to March...
Unrecognized cross-contamination has been known to occur in laboratories frequently, especially with sensitive recovery system like BACTEC 460 TB. In March 2001, we investigated a pseudo-outbreak of Mycobacterium tuberculosis isolates in three smear negative clinical specimens and would like to present our experience in this communication.
All susp...
Unrecognized cross-contamination has been known to occur in laboratories frequently, especially with sensitive recovery system like BACTEC 460 TB. In March 2001, we investigated a pseudo-outbreak of Mycobacterium tuberculosis isolates in three smear negative clinical specimens and would like to present our experience in this communication. Methods:...
Accidental exposure from blood/body fluid of patients is a risk to healthcare workers (HCWs). Percutaneous injury is the most common method of exposure to blood-borne pathogens. A policy was formulated at our institute, a tertiary care centre in central Mumbai, and we report a six-year (1998--2003) ongoing surveillance of needlestick injuries. Of t...
-lactamases represent the most common mechanism of -lactam resistance. Extended spectrum -lactamases (ESBLs) represent a major group of -lactamases currently being identified worldwide in large numbers along with inducible AmpC -lactamases and derepressed mutants. The present study was done to detect -lactamase production in clinical isolates by re...
The aim of this study was to perform pyrazinamide (PZA) susceptibility testing of M. tuberculosis by enzymatic PZA assay and compare the results with radiometric BACTEC 460 TB system and LJ proportion method. One hundred and thirty clinical isolates of M. tuberculosis were included in the study. Of the 130 clinical isolates tested, five were resist...
Background:Present scenario of tuberculosis (TB) demands a reliable method for rapid diagnosis of TB. Several newer methodologies have been introduced over last 2 decades. However, clinical evaluation of all these methods is essential before bringing them into routine diagnostic practice. Aim: In the present study, we have evaluated 3 most promisin...
Wound infection is an important cause of morbidity and occasional mortality after coronary artery bypass graft surgery (CABG). The aim of this study was to report postoperative wound infection in CABG surgery patients.
Consecutive patients undergoing CABG surgery between January 1998 and October 1999 have been studied. The exclusion criteria includ...
Increase in multidrug-resistant M.tuberculosis (MDR-TB) has become a great cause of concern and rifampicin resistance is considered to be a good predictor of MDR-TB in many parts of the world. Its rapid detection will allow alteration in treatment regimens in time to reduce the spread of the disease. Detection of rifampicin resistance by phage assa...
Rapid diagnosis of tuberculosis is essential to initiate timely and appropriate treatment to curb the spread of this potentially life threatening disease. The purpose of this study was to evaluate a phage amplification technology viz., FASTPlaque TB, for the diagnosis of tuberculosis.
We evaluated the clinical utility of this new assay by analyzing...
A study was undertaken to determine Hepatitis B virus DNA (HBV DNA) by PCR in acute and chronic hepatitis B infection and to correlate it with serological markers. Three hundred and forty-five serum samples of patients from all over India were categorized into different groups according to their serological profile. HBV DNA was detected upon amplif...
Since 1987 there has been a slight increase in tuberculosis cases in the UK. This has been mainly due to immigration from Africa and the Indian subcontinent. There is evidence of an increasing incidence of drug resistance in patients presenting from these countries but because of the difficulty and expense of sensitivity testing, good data on drug...
In todays world, good infection control practices in high pressure intensive care units is of vital importance. Endogenous infections from the patients own microbial flora now cause the majority of nosocomial infections as the exogenous infections are curtailed to a large extent with aggressive surveillance and prevention of infection. We analysed...
Infection of intracranial catheters is a common complication of ICP monitoring. The introduction of a simple technique of ensheathing the entire length of the external segment of the catheter in a sterile plastic sheath resulted in a decreased infection rate. In the study year, one of 78 patients developed catheter-induced meningitis, compared with...
Catheter infection is the most frequent complication associated with vascular catheter use. We compared 150 catheters from 79 septic patients and another 150 catheters from 75 nonseptic patients. There was a significantly lower infection rate (9.3%) in the nonseptic patients compared to septic patients (39%). The exogenous catheter infection rate i...
Purpose: To study the resistance profile of M. tuberculosis in a tertiary referral centre in Bombay. Methods: A retrospective evaluation was undertaken of pulmonary and extra-pulmonary culture positive tuberculosis over a 2 year period (1994-1995). The source of data was the mycobacterial laboratory records from which all culture positive isolates...
Chloramphenicol resistance to Salmonella typhi in 1989 was 16% in Hinduja Hospital. From Jan to June 1990, this resistance has increased to 81%. 74 strains of blood culture isolated of S typhi obtained from Jan to June were subjected to antibiotic sensitivity testing by disc diffusion technique of Kirby and Bauer 60 strains were found to show a blo...
Citations
... This shows that there was a high agreement between mCIM and Xpert Carba-R in the detection of carbapenemase enzyme. This finding is correlating with the results of previous studies by Patel [20,27]. These findings conclude that though mCIM test has a longer turnaround time due to overnight incubation, mCIM is suitable for a resource-poor microbiology laboratory as it is inexpensive, easy to perform, less subjective with a more reliable sensitivity compared to CarbaNP test. ...
... From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher [7] . In a systematic review and meta-analysis about global prevalence of nosocomial infection was conducted a comprehensive search of electronic databases including EMBASE, Scopus, PubMed and Web of Science between 2000 and June 2021. ...
... The selection of clofazimine-resistant M. tuberculosis isolates has been demonstrated in vitro (Hartkoorn et al., 2014) and reported in clinical isolates (Xu et al., 2017;Nimmo et al., 2020a). The MIC distribution of clofazimine in mycobacterial growth indicator tube (MGIT) culture systems ranges between 0.125 µg/mL-0.5 μg/mL for pan-susceptible and 0.25 µg/mL-1 µg/mL for DR-TB strains (Ismail et al., 2019), with a critical concentration of 1 μg/mL recommended by the WHO (World Health Organistation, 2018). Reliable estimates of the prevalence of clofazimine resistance are not available. ...
... However, this relies on the accurate identification of pathogenic microorganisms and AMR. Different methods are available for AMR detection or prediction, ranging from traditional (gold standard) culture-based techniques to PCR-based molecular detection and, more recently, sequencing-based methods [3,4]. The gold standard phenotypic susceptibility testing (PST), which requires positive culture growth before conducting drug susceptibility testing, is typically time-consuming [5]. ...
... a Healthy human serum; b healthy bovine serum and prone to cross-contamination, which also limits its application in certain regions (Kunnath-Velayudhan et al. 2012;Mukamolova et al. 2010). In vitro isolation of MTB is considered the "gold standard" for the diagnosis of pulmonary and extrapulmonary tuberculosis, with a high detection rate and strain identification, but these methods have limited sensitivity and specificity, are time-consuming (6-8 weeks), and are not very useful for early diagnosis (Nambiar et al. 2017;Pai et al. 2014). The TB PPD skin test is a commonly used clinical immunological test that is used for the detection of TB due to its simplicity and speed, but it cannot clearly distinguish between BCG immunization and pathogenic MTB infection, has low differential diagnostic value, and is prone to high false-positive and false-negative results (Mosavari et al. 2021). ...
... 34 The predilection towards women in EPTB cases could be attributed to self-neglect towards health and later presentation of active TB as EPTB. [36][37][38] According to the WHO global TB report, the prevalence of MDR-TB in new and previously treated cases was 2.5-2.8% and 14-17%, respectively. 39 As a high TB burden country, India is also a hotspot region for MDR-TB infection. ...
Reference: 2023 Summer
... The global spread of carbapenem-resistant Enterobacterales (CRE) represents a serious public health concern as these pathogens are associated with limited treatment options, high mortality rate and rapid transmissibility (1,2). Mechanisms underlying carbapenem resistance are related mainly to the production of carbapenemases (carbapenemase-producing Enterobacterales, CP-CRE), but also a consequence of decreased membrane permeability coupled with the overexpression of extended-spectrum β-lactamases (ESBLs) or AmpC β-lactamases (non-carbapenemase-producing carbapenem-resistant Enterobacterales, non-CP-CRE) (3)(4)(5). ...
... Incomplete eradication of tuberculosis during medical treatment allows pathogens to remain in the patients. This remaining bacterial population can result in refractory tuberculosis (Davies, 2001), where genetic mutation-conferred drug resistance may play a part, but bacterial persistence is believed to be the primary cause (Wayne, 1994). Many persisters are found in a microenvironment known as a granuloma (Davies, 2001;Honer Zu Bentrup & Russell, 2001), which creates difficult conditions such as high oxidative stress, low pH, and limited nutrients that induce persister formation (Davies, 2001;Honer Zu Bentrup & Russell, 2001;Marakalala et al., 2016;Mok et al., 2015;Rubin, 2009). ...
... In 1996, the private, not-for-profit Hinduja Hospital in South Mumbai published data on its TB patients, of which 32% had MDR-TB and 8% were XDR-TB cases. This created quite a debate among public health experts in India (Udwadia et al. 1996;Udwadia 2001). The mycobacterial laboratory serves as a reference laboratory for Mumbai and reported in 2001 that around 60% of all isolates it receives are MDR-TB (Udwadia 2001). ...
... Soman et al., 2015, reported a series of five cases of coronary stent infection caused by rapidly growing mycobacteria (RGM), which lead to infective endocarditis. Four out of five patients died due to complications of infective endocarditis, and the reuse of balloon angioplasty catheters was thought to be the plausible cause behind this complication [10]. Formation of coronary-cameral fistula secondary to coronary stent infection has also been reported [11]. ...