Indian Journal of Microbiology Research

151-153

Authors: Balan K., Abirami Lakshmy, Ashwini MA, Vijayalakshmi TS., Sheila Doris Devamani

Group B streptococci(GBS) is one of those pathogens causing neonatal septicaemia and neonatal meningitis. Objective of this study is to screen antenatal women for Group B Streptococcus colonization and its antibiotic sensitivity pattern by Kirby bauer disk diffusion method. This study was carried out in Department of Microbiology during a period of 4 months.A total of 100 pregnant women attending antenatal clinics in the age group 20-40 years were included in the study. Two vaginal swab were taken aseptically and immediately transported to the laboratory for processing. One swab for direct gram staining and other swab was inoculated into sheep blood agar and incubated at 37 ºC for 24-48 hours. Identification of organism was based on gram staining, colony morphology, catalase reaction, Christie Atkins Munch Peterson(CAMP) and Hippurate hydrolysis test. Results of this study show that prevalence rate for GBS colonization is 8%.Pregnant women less than 20 years of age and primigravida are more commonly colonized with Group B Streptococci. All the isolates were sensitive to Penicillin, Erythromycin, Ampicillin, Gentamicin, Ceftriaxone and Chloramphenicol. Hence all pregnant women should be screened for Group B Streptococci carriage between 35 and 37 weeks of gestation and intrapartum antibiotic prophylaxis be given to colonized women at the time of labour or rupture of membranes

158-162

Authors: Charanjeev kaur, Poonam Sharma, Sarbjeet Sharma

aeruginosa is one of the major organisms responsible for nosocomial infections such as pneumonia, UTIs, surgical site infections, and bloodstream infections.1 High intrinsic and acquired resistance to many antimicrobial agents have allowed P. aeruginosa to persist in both community and hospital settings. This study was done to find the prevalence rate of Meropenem resistant Pseudomonas aeruginosa carrying metallobeta lactamase producing genes. Materials and Methods: The study included a total of 100 non-duplicate clinically significant, random bacterial isolates obtained from a North Indian rural tertiary care hospital (Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India) from various clinical specimens, over a period of one year (January2012 to December 2012) . Identification of organisms was done using the standard microbiological techniques as described by Colle et al 1996.7 The antimicrobial susceptibility testing was performed by Kirby Bauer disc diffusion method. To detect MBL producing isolates phenotypicaly, Disc potentiation test (DPT) and Double disc synergy test (DDST) were performed. PCR was performed on Meropenem resistant isolates to detect blaIMP and blaVIM genes. Results: Out of 100 examined isolates, 36% isolates were resistant to Meropenem. Out of these Meropenem resistant strains, 44.4%(16) P. aeruginosa isolates were MBL producers as detected by DDST method and 69.44%(25) isolates were MBL producers phenotypically by DPT method . PCR revealed prescence of bla VIM gene in 16.66%(6) of Meropenem resistant Pseudomonas aeruginosa isolates and 38.88% (14) isolates were found to be carrying bla IMP gene . Three isolate were shown to carry both blaIMP and blaVIM genes. Conclusion: Resistance of P. aeruginosa isolates to Meropenem due to MBL enzymes is increasing in rural area. Resistance due to MBL has clinical significance, rapid detection of MBL producing strains followed by appropriate treatment is necessary to prevent the spreading of these organisms

168-170

Authors: Deepak Arora, M K Mahajan, Manjit Kaur, Parvinder Singh

Hepatitis C virus (HCV) infection results in persistent liver disease, cirrhosis and hepatocellular carcinoma. Significant association has been seen between HCV and cancer .Prevalence of HCV infection in cancer patients range from 1.5% to 32%. Aim of our study: To evaluate the Sero prevalence of hepatitis C among patients with malignancy reported at ACI, Bathinda. Materials and Methods:The study was done in Advanced cancer hospital in Bathinda for a period of 1 year & 6 months from 1.5.16 to 31.10.17. All the specimens were screened using immune chromatographic assays. The data was statistically analysed. Results: Positivity of HCV in cancer patients in our Cancer hospital was 6.6% In our cancer patients HCV was found to be more prevalent in females (6.6%) as compared to males (6.4%). 100% of cases which were reported from rural background. In males the risks for the cancers of the upper digestive tract, mandible, neck, oesophagus, and lung were higher. Tobacco exposure and alcohol use explain increase in risk .Of the 21 cases of females 12 cases of carcinoma breast, 2 Endometrial carcinoma, 1 liver carcinoma ,2 ovarian carcinoma, 1esophagal carcinoma & 2 kidney carcinoma were reported. Maximum number of cases were in age group of 41-70 with 28 cases in age group of 50-60 years. One patient was reported HCV positive at 94yrs. Conclusion:Prevalence of HCV is high in cancer. Maximum number of patients are from rural background. These patients are apprehensive to report to hospital and get examined. So, the message is very clear that either medical services in our rural areas need to be strengthened and practitioners sitting in rural population need to be educated or to look to traditional Indian medicines to which these rural population have faith like preventive aspects with the strengthening of AYUSH systems. As maximum number of cases are in females and with carcinoma of breast suggest the urgent need to educate females regarding healthy sexual practices &lifestyle modifications

174-178

Authors: Vinay Hajare, Mohammed Abdul Hadi Waseem, Aaftab G P

Introduction: The association of Helicobacter pylori with peptic ulcers has gained its importance and has led to ongoing research for the most appropriate treatment. Combinations of multiple drugs presently are having best cure rates. Materials and Methods: Based on clinical signs and symptoms, 96 patients were selected for study purpose, out of which 34 patients were positive for Helicobacter pylori. Identification was done based on Direct Gram stain, Gram stain of the colony, positive oxidase, catalase and urease test. Antimicrobial susceptibility testing was carried out with agar dilution method using 5-drugs namely clarithromycin, levofloxacin, metronidazole, amoxicillin and tetracycline. Results: Out of the 34 isolates, 6 isolates were resistant to clarithromycin (17.6%), 5 isolates were resistant to levofloxacin (14.7%), 20 isolates showed resistance to metronidazole (58%), only one isolate showed resistance to amoxicillin (2.9%) and 2-isolates showed resistance to tetracycline (5.8%) . In this study higher resistance was seen to metronidazole as the drug is widely used in India for the treatment of Amoebic dysentery. Compared to males, female patients showed higher resistance to metronidazole (92%) due to its use in the treatment of trichomonas vaginalis infection. Conclusion:Most patients are prescribed initial Helicobacter pylori eradication treatment without culture and antimicrobial susceptibility testing. Emergence of resistance is thought to be due to prior antibiotic use hence irrational use of antimicrobial should be stopped to prevent drug resistant.

184-187

Authors: Jyoti Srivastava, Abhay Srivastava, Amita Arya, Ranjan Agrawal

Introduction: Asymptomatic bacteriuria (ASB) is a condition characterised by significant infection in urine. Its association with diabetes mellitus is strongly suggested. However, the exact prevalence has been controversial. Objectives: The study was undertaken with the aim of evaluating the prevalence and aetiology of asymptomatic bacteriuria in diabetics as well as non-diabetics. Materials and Methods: A total of 460 patients were included in the study with 230 diabetics and 230 non-diabetics. Midstream clean catch urine samples were collected alongwith parallel blood samples for estimating the glycosylated haemoglobin levels. Results: Of the total 460 subjects, 78 (17.0%) had ASB with 56 in diabetics and 22 in non-diabetics, depicting a higher rate of ASB in diabetes mellitus. Majority of the patients who had ASB were aged more than 60 years, irrespective of whether in the diabetic or non-diabetic category. Also, there was a significant difference in the type of infective organism in urine from diabetic patients as compared to the non-diabetic patients. Conclusion: A higher prevalence rate of ASB was observed in diabetic patients as compared to non-diabetics. Furthermore, the newer infecting organisms that are more common in patients with diabetes mellitus was highlighted in the study

194-197

Authors: Rajeswari Jayakumar, Vijayalakshmi Arumugam, Meerah Srinivasagam

Introduction and Objectives: CoNS which were considered as contaminants with minimal significance, have emerged as important agents of human disease. The recognition of increasing antimicrobial resistance among CoNS isolates constitutes a potentially worrisome emerging characteristic. Hence, this study was done to speciate and determine the resistant pattern of CoNS. Materials and Methods: 122 clinically significant CoNS isolates were obtained from various clinical samples between August 2016 to July 2017. These samples were processed conventionally. Results: Of the 122 CoNS species isolated majority were from pus. Identification of CoNS showed S.epidermidis 70 (57.4%), as the most frequently isolated species. Antimicrobial susceptibility pattern of the isolates showed maximum resistance to Penicillin. Methicillin resistance was seen among 19 (15.6 %) isolates. But all the isolates showed 100% sensitivity to glycopeptides and Linezolid. Conclusion: Meticulous identification, speciation and resistant pattern of the isolate is of paramount importance in clinical management of patients

202-207

Authors: A. Swati, K. Yamini, R. V. Rajkumar

Introduction: Endotracheal aspirates ( ET) are relatively simple ,easy to collect at the bedside and are used to evaluate the causes of lower respiratory tract infections in ventilated patients.Several studies reported multidrug resistant bacteria like Klebsiella, Pseudomonas and Acinetobacter spp,gram positive bacteria like S.aureus, S.pneumoniae ,Coagulase negative staphylococcus (CONS) and fungi like Candida spp in ET cultures. Even though Quantitation of the bacteria isolated from ET aspirates has been proposed as a criterion to distinguish colonization from true infection, only few studies have been done .The main aim of the present study was to evaluate the microbiological spectrum and antimicrobial susceptibility pattern of isolates from ET aspirates. Materials and Methods:ET aspirates were processed employing quantitative cultures. Growth of ?105cfu/ml was considered to be significant.Organism Identification and Antimicrobial susceptibility testing was performed according to standard guidelines. The gram negative isolates were further tested for ESBL/carbapenamase production and gram positive as methicillin sensitive / methicillin resistance. Results:Culture positivity was 67%. Acinetobacter spp was the most common isolate (46%) followed by Klebsiella spp (26%) and Pseudomonas spp (17%), E.coli (5%), S.aureus (2%), CONS (2%) and Candida (2%). Acinetobacter spp were extremely drug resistant. ESBL was produced by 38% and 64% of E. coli and Klebsiella spp. Out of the 15, 40% of the Pseudomonas spp and of 127 isolates, 63.7% of Acinetobacter spp were positive for carbapenamase production respectively .Out of the 7, 6 (86%) were methicillin resistant Staphylococcus aureus.5 (83%) of CONS (n=6) were methicillin resistant. Conclusion:We conclude that ET microscopic examination and quantitative cultures can be supportive in earlier prediction of ventilator-associated pneumonia.

213-217

Authors: Kailash Wagh, Nagendra A., Amit Vairagade

Water used for human consumption must be safe and free from microbes. Storing water in copper has been used since long time in India, also evident in ancient texts of Ayurveda. Present study aims to evaluate the efficacy of various water storing vessels in purifying drinking water especially in terms of antibacterial (anti-Escherichia coli) activity. The water was collected from Waghur River, Jalgaon and stored in different vessels for 5 days like copper, stainless steel and plastic.Bacterial growth was observed before and after storage. We found the significant reduction in the number of coliform bacteria in water stored in copper vessels than stainless steel and plastic vessels. We observed the benefit of using a copper-based device, which is effective and cheap for storage of water and can be used to made bacteria free water

224-228

Authors: Meena Dias, Rakhshitha Puroshotam Eashwernath

Chlamydia trachomatis infection is the most common sexually transmitted bacterial infection worldwide, affecting women more than men. Majority being asymptomatic, this infection goes unnoticed and will have a major impact on the reproductive health of women resulting in morbidity. It also increases the risk of HIV. Objective:To detect the Chlamydial infection in symptomatic women of reproductive age group and to identify the possible risk factors. Materials and Methods: An endocervical swabs were collected from 100 symptomatic patients of reproductive age group and subjected to direct fluorescent antibody test (DFA). Results: The C.trachomatis infection was 20%, with a higher positivity in the age group of 26- 30 years. The most presenting complaint was vaginal discharge. A significant past history of PID, coppet T insertion, IUD/still birth was noted. A 20% coinfection with candiadiasis was also observed. Conclusion: As the occurence of Chlamydia trachomatis was substantially high in our study, effective strategies to implement screening programmes should be initiated as a routine diagnostic test for all women of reproductive age group, thereby preventing severe sequelae by providing timely management.

236-239

Authors: Vijetha Sajjanar, D. E. Premalatha

Introduction: Neonatal septicemia is important cause of neonatal mortality and morbidity. Neonatal Coagulase negative staphylococci(CoNS) infections are rarely fatal, but they cause significant morbidity, especially among very low birth weight infants. Objectives of the study:1. To know the prevalence of CoNS in neonatal sepsis; 2 To determine the antibiotic susceptibility pattern of CoNS in neonatal sepsis. Materials and Methods: A prospective study was conducted on blood samples of suspected neonatal septicemia between July 2017 and December 2017 received at Department of Microbiology, SIMS, Shimoga. Under aseptic precautions samples were collected and inoculated into BHI broth and subcultures were performed on MacConkey agar and blood agar plates and growth was processed by standard bacteriological technique. Antibiotic susceptibility testing was performed by Kirby Bauer Disk Diffusion test. Results were interpreted as per CLSI guidelines. Results: Out of 156 samples 98 were culture positive and 58 were culture negative. Most common organism isolated was Coagulase negative staphylococci(CoNS) 48.97%(48/98),Klebsiella species21.4%(21/98),Staphylococcus aureus10.2%(10/98),Gram Negative non fermenters 9.1%(9/98),Escherichia coli 2.04%(2/98), Citrobacter spp 4.08%(4/98),Pseudomonas spp 1.02%(1/98),Enterococcus spp 1.02%(1/98),Streptococcus spp 1.02%(1/98),Candida spp 1.02%(1/98). Gram positive organisms were highly sensitive for Linezolid, Vancomycin moderately sensitive for Gentamicin, Cotrimoxazole, ciprofloxacin and least sensitive for Erythromycin, Clindamycin, ciprofloxacin, Azithromycin, Cefoxitin(MRCoNS) Conclusion: This study showed emergence of Coagulase negative staphylococci(CoNS) as the most common pathogen in neonatal septicemia. Prevalence of MRCoNS and multidrug resistance among Coagulase negative staphylococci(CoNS) is seen

244-248

Authors: Manmeet Gill, Sarabjeet Sharma, Ashish Khanna

Introduction: Over past few years, a dramatic increase in the incidence of infections caused by Candida species is seen, which has been attributed to increased number of immunocompromised patients, widespread use of broad spectrum antibiotics, long term use of corticosteroids and immunosuppressive drugs, prolonged hospital stay and use of advanced life support systems Aims and Objectives:To determine the incidence of Candida infections among patients admitted to a tertiary care teaching hospital of north India, characterise Candida isolates upto to specie level and also to evaluate presence of any drug resistance among these strains. Material and Methods:Present study was a hospital based prospective study carried out in the Department of Microbiology, of a tertiary care hospital in north India, over a period of one year from June 2016 to May 2017. For all Candida isolates obtained from various clinical samples, identification to the species level and anti-fungal susceptibility testing was done by automated Vitek 2 compact system (Biomerieux). Results were interpreted as per CLSI guidelines. Results:A shift of trends from Candida albicans to non albicans Candida was observed as out of total 56 isolates, the number of Candida albicans isolates was 16 (28.6%) and non-albicans Candida was 40 (72.4%). Anti-fungal susceptibility test results showed high susceptibility to Voriconazole and Amphotericic B. Only 5.35% (3/56) of Candida isolates showed resistance. Conclusions: Since non albicans Candida has emerged as an important nosocomial pathogen and these species are intrinsically resistant to some of the commonly used anti fungal drugs so anti-fungal susceptibility should be routinely performed to improve the treatment outcomes, for the benefit of the patient.

252-257

Authors: Vamsi Chakradhar Kapaganty, Rajeswari Pilli

Introduction: Ventilator-associated pneumonia (VAP) is defined as pneumonia occurring more than 48 hours after the initiation of endotracheal intubation and it is the most common nosocomial infection in the intensive care unit (ICU). VAP is one of the important nosocomial infection that is the cause of significant morbidity and mortality among patients on mechanical ventilation. Aim of the study: This prospective study was undertaken with an objective to determine the common etiological agents and their antimicrobial sensitivity patterns of VAP in our institute. Results: Among the 134 mechanically ventilated patients and 56 of them developed VAP. Among the causative agents, Pseudomonas and Escherichia coli were most common among gram negatives and Staphylococcus aureus was common among the gram-positive isolates. Eighteen of the 56 isolates (32%) were polymicrobial. Thirty-eight isolates from VAP patients were multi-drug resistant (MDR) pathogens. Conclusion:High incidence of VAP and the potential MDR pathogens are a real threat in our ICUs. Combined approach of judicious antibiotic usage and training programs to health care personnel might be of help in combatting high incidence of antibiotic resistance in our institute

266-270

Authors: Sandip Bandopadhyay

Introduction: Immobilization of the whole cell is a modern approach to fermentative production of different enzymes. The technique has several advantages including easy separation of the fermented product, least chance of contamination and no chance of wash out of cells during product recovery. Materials and Methods: ?-amylase produced from Calcium alginate entrapped cells of Bacillus thuringiensis A5-BRSC was purified by ammonium sulphate precipitation, followed by DE-52 ion exchange column chromatography. The molecular weight of the purified enzyme was determined by SDS-PAGE. Study of enzyme kinetics was performed to determine its enzymatic potency. Results: Immobilization of Bacillus thuringiensis A5-BRSC cells in calcium alginate resulted in more than 3.5 times higher ?-amylase activity than free cells within 48 hours of batch fermentation. The molecular weight of the purified enzyme was estimated to be 52 kDa by SDS-PAGE. The enzyme exhibited pH optima at 6.9 and temperature optima at 500C. KM and Vmax of the purified enzyme was determined to be 0.85 mg/ml and 0.98 mg of liberated maltose/ml of enzyme/minute. Conclusion:?-amylase produced form the immobilized cells found to be more potent than the enzyme produced by the free cells

275-279

Authors: Sathish J. V., Trupti B. Naik, P. Vamsi Muni Krishna, Asmabegaum Biradar

Introduction: Dengue fever is an emerging acute febrile illness caused by arboviruses and presenting with wide spectrum of clinical manifestations ranging from self-limiting asymptomatic infection to severe fatal infection like Dengue hemorrhagic shock with unpredictable outcome. It is endemic in India and in recent years it is appearing in the form of epidemics especially during rainy season. Objectives To determine seroprevalence of dengue virus among clinically suspected cases. To determine the seasonal variation of dengue infection in the study setting. To study the demographic profile of dengue positive patients. Materials and Methods: A cross sectional study was done at a tertiary care hospital, Chamarajanagar using secondary data which were maintained in the microbiology laboratory registers, for clinically suspected dengue patients reported to the hospital from January- December 2017. Prevalence was estimated by analyzing data for the results of both NS1antigen and IgM antibody by ELISA tests and any variations in disease reporting by gender, age and season were assessed. Statistical analysis was done using WHO Epi info software version 3.5.4. Results:A total of 2213 serum samples were analyzed during the study period. Out of which 475 samples (21.46%) were found positive for dengue infection either by NS1 or IgM ELISA. The proportion of dengue cases was higher in monsoon season with maximum rate of positivity in August (55.37%). Paediatric population was the most common affected group (30.33%). Conclusion:The present study confirms that dengue is mainly a disease of rainy season and also identifies certain vulnerable groups for effective planning of interventions.

284-287

Authors: Sarah Hassan, Vineeta Khare, Mastan Singh, Syed Abid Asghar

Introduction: Dengue viruses are Arboviruses capable of infecting humans, and causing diseases1.Dengue virus belongs to the family Flaviviridae, genus Flavivirus. The Aedes aegypti mosquito is the principal vector that transmits the viruses that cause dengue.The viruses are passed on to humans through the bites of an infective female Aedes mosquito, which acquires the virus while feeding on the blood of an infected individual. Commercially available rapid kits, detecting the presence of NS1 antigen and anti-dengue antibodies have been developed for the rapid detection of dengue.Diagnosis of dengue at an early stage is the only effective way to control disease progression. Objective: To compare rapid immunochromatographic test with ELISA for detection of NS1antigen and IgM in suspected dengue patients. Materials and Methods: A Cross-Sectional study was carried out in the Department of Microbiology, Era’s Lucknow Medical College and Hospital from the month of July 2016 to September 2016.Serum samples of 225 suspected dengue patients were collected, having fever for 5 days or less. All samples were analyzed by Dengue Day 1 Test which detects NS1 antigen, IgM and IgG antibodies; by Panbio Dengue Early ELISA for detecting NS1 antigens and by Panbio Dengue IgM Capture ELISA for IgM antibodies. Results:The Rapid Dengue Day 1 card Test showed a sensitivity and specificity of 92% and 98% for NS1 antigen detection and 90% and 100% for IgM Antibody detection. Conclusion: High sensitivity and specificity of rapid diagnostic tests for early detection of dengue was observed. These kits are highly suitable for early detection of positive cases, as with high sensitivity and specificity it can help in early screening of patients and can further limit the spread of disease.