Showing papers by "Belgode Narasimha Harish published in 2010"

ACC-1 β-Lactamase–producing Salmonella enterica Serovar Typhi, India

Abstract: To the Editor: Typhoid fever, caused by Salmonella enterica serovar Typhi, is a serious form of enteric fever. In 2000, the worldwide number of typhoid cases was estimated to be >21,000,000, and there were >200,000 deaths from this disease (1).

Molecular characterization of antimicrobial resistance in non-typhoidal salmonellae associated with systemic manifestations from India.

Abstract: Extended-spectrum cephalosporins and fluoroquinolones are essential antimicrobials for treating invasive salmonellosis, although emerging resistance to these antimicrobials is of growing concern, especially in India. Therefore, a study was conducted to characterize the antimicrobial susceptibility phenotypes, types of extended-spectrum β-lactamase (ESBL) gene plasmids and serological relationships of 21 non-typhoidal Salmonella isolates from patients who attended three different hospitals in India from 2006 to 2008. The isolates were cultured from stool, blood and cerebrospinal fluid samples obtained from patients presenting with diarrhoea and accompanying systemic manifestations such as fever, vomiting and meningism. Non-typhoidal Salmonella isolates were investigated using serotyping and antimicrobial susceptibility testing. PCR screening was also performed to detect the β-lactamase, qnr and aac(6')-Ib-cr genes and class 1 integrons. Sequencing for quinolone resistance mutations and plasmid replicon typing were also performed. An antimicrobial resistance microarray was used for preliminary screening and identification of bla(TEM) and bla(SHV) genes, and phenotypic testing for the presence of efflux pumps was also performed. Ten out of 21 isolates (48%) possessed the extended-spectrum cephalosporin resistance phenotype, with PCR amplification and sequencing revealing that isolates possessed TEM-1, SHV-12, DHA-1, OXA-1-like and CTX-M-15 ESBL genes. FII(s) plasmid replicons were detected in seven isolates (33%). The involvement of efflux pumps was detected in four isolates (19%) resistant to ciprofloxacin. It was concluded that SHV-12-carrying Salmonella serotype Agona may play an important role in ESBL-mediated resistance in non-typhoidal salmonellae in India. The very high percentage (48%) of ESBL-producing non-typhoidal salmonellae isolated from these patients represents a real and immediate challenge to the effective antimicrobial therapy of Salmonella infections associated with systemic manifestations. Continued surveillance for the presence of ESBL-producing (non-typhoidal) salmonellae in India is essential.

Clinical and serological evaluation of Leptospirosis in Puducherry, India.

Abstract: Background: Leptospirosis is a zoonotic disease with a worldwide distribution. There is a paucity of available data about prevalence of this disease in Pondicherry. Our aim was to investigate the seropositivity rate of leptospirosis in suspected cases and also to identify the predominant serogroups present by performing Microscopic Agglutination Test (MAT). The other aim of this study was to compare the results of a commercially available IgM ELISA with that of MAT. Methodology: A total of 110 blood samples from patients suspected of leptospirosis were sent for diagnosis. These samples were subjected to IgM ELISA and the microscopic agglutination test (MAT). MAT was done using a panel of 12 Leptospira serovars. Results: MAT analysis of the 110 samples showed 40 (36%) to be positive. Antibodies were predominantly seen against serogroup Leptospira Icterohemorrhagiae (27%), followed by Pomona (17%), and Pyrogenes (12%). IgM ELISA done on these samples showed a positivity of 37% compared to MAT. Conclusion: This study reveals that the MAT test can be standardized in a diagnostic laboratory and used in conjunction with an IgM ELISA.

Streptomyces bacteremia in a patient with actinomycotic mycetoma.

Abstract: A 29-year-old woman presented with multiple painful swelling with discharging sinuses over the scalp. Histopathological examination of the biopsy tissue was suggestive of actinomycotic mycetoma. Streptomyces spp. was isolated from blood culture. The patient was successfully treated with trimethoprim-sulfamethoxazole and crystalline penicillin. This case is reported because of the rare occurrence of bacteremia by Streptomyces spp. secondary to subcutaneous actinomycotic mycetoma. Moreover, an interesting association between successive two pregnancies and occurrence of mycetoma of the scalp was observed in this case.

Hemophagocytic syndrome in a child with brucellosis.

Abstract: The authors report case of a two and half years old female child presented with fever for one month with hepatosplenomegaly. Though the child had been symptomatic for a prolonged period, she did not appear very unwell at presentation. However, after admission there was sudden rapid deterioration of her clinical status. Investigations revealed hemophagocytosis with brucella infection.

Diagnosis of Leptospirosis by Polymerase Chain Reaction

Abstract: Leptospirosis is an important emerging zoonotic infection in developing regions of the world. Laboratory testing for leptospiral infections is important both for diagnosis and management of the patients. The conventional laboratory methods for diagnosis have many shortcomings. The availability of molecular techniques like Polymerase Chain Reaction (PCR) as diagnostic tool has improved speed and accuracy of detection. In this study serum samples from 100 patients were tested by the microscopic agglutination test MAT, IgM ELISA and PCR. The clinical symptoms mainly observed among the patients were fever (98%), jaundice and headache (78%), myalgia (77%). Among the 33 cases of leptospirosis diagnosed by MAT, 29 (87.9%) serum samples were positive by IgM ELISA and 4 (13%) were PCR positive. By considering MAT as the standard test, the sensitivity and specificity of IgM ELISA was 43% and 76%, respectively. A relevant finding in our study was the number of positive cases verified by PCR 4/28(14.3%) and IgM ELISA 11/28(39.3%) among the 28 unconfirmed cases by MAT, demonstrating the value of PCR in the diagnosis of human leptospirosis.

IgM Dot-ELISA assay using prevalent Leptospira strain for diagnosis of leptospirosis.

Abstract: Background: A test strip IgM Dot-ELISA assay for the detection of leptospirespecific IgM antibodies in human sera was developed. Antigen dotted on a nitrocellulose paper strip was the sonicated antigen prepared from Leptospira serovar prevalent in this area, i.e., Icterohaemmorhagiae. Objective: The aim of this study was to evaluate an in- house prepared IgM Dot- ELISA test strip for the diagnosis of leptospirosis. Material and methods: The ability of the IgM Dot- ELISA to diagnose leptospiral infection was evaluated by testing 125 serum samples, 75 serum samples from 93 laboratory-confirmed leptospirosis case patients with positive result in the standard microscopic agglutination test (MAT) and 25 serum samples from patients with various diseases other than leptospirosis and 25 from healthy individuals. The results of Dot- ELISA were also compared to that of a commercially available IgM ELISA. Results: Using the results of the MAT as a gold standard, the sensitivity and specificity of the test strip IgM dot-ELISA assay were 97.33% and 96.00%, respectively. The assay showed relatively good negative predictive values (96.00%) thus making the assay ideally suited for rapid screening. Conclusion: In conclusion, the test strip IgM dot-ELISA assay was sensitive enough for use as a screening test for serodiagnosis of leptospirosis. The assay was simple, inexpensive, and easy to perform for both a single test format and a large number of specimens.

Leptospirosis in a case of non-Hodgkin lymphoma.

Abstract: Leptospiral meningitis, which is an important feature of anicteric leptospirosis, is generally underdiagnosed. Serological tests are not very useful in diagnosis of leptospiral meningitis. Early detection by molecular tests such as PCR and prompt institution of therapy would be life-saving.