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Punia P, Bala K, Verma M, Nandi A, Mahlotra P, Singh S, Garg S, Parmar A, Kumar D. Feasibility of a "No-Biopsy" Approach for the Diagnosis of Celiac Disease in Symptomatic Adults. Cureus 2024; 16:e54578. [PMID: 38523934 PMCID: PMC10957510 DOI: 10.7759/cureus.54578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/26/2024] Open
Abstract
Celiac disease (CD) is an immune-mediated enteropathy, caused by hypersensitivity to gluten in genetically predisposed individuals. The worldwide prevalence of CD has been estimated to be approximately 1%. Most guidelines for diagnosis of CD rely on a sequential approach, with serological testing of antibodies against tissue transglutaminase (tTG) as a first-line test, followed by a duodenal biopsy. However, GI biopsy is an invasive procedure with various complications. Hence, this study was planned to ascertain whether it could be possible to have a non-biopsy approach, using only serological markers to establish the diagnosis of CD in adults. MATERIAL AND METHODS It was a retrospective analysis of medical records of all biopsy-diagnosed CD patients with available anti-tTGA antibodies reports from 2019 to 2023. The patients were divided into three groups based on Marsh grading and anti-tTGA antibody levels were compared using various statistical tests. RESULTS A total of 94 biopsy-diagnosed symptomatic CD patients with anti-tTGA antibody reports available formed the study group. Of these, 54 had biopsy findings consistent with Marsh 3 lesion, three had Marsh 2 lesion, and 37 had Marsh 1 lesion. A significant correlation existed between Marsh grading 3 lesion and anti-tTGA antibody levels above the upper limit of normal (ULN) x 10. CONCLUSION Serum levels of anti-tTGA antibodies greater than 10 x ULN can be used to identify symptomatic patients with Marsh grade 3 CD lesions.
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Affiliation(s)
- Parul Punia
- Microbiology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
| | - Kiran Bala
- Microbiology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
| | - Mansi Verma
- Microbiology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
| | - Ankita Nandi
- Microbiology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
| | - Parveen Mahlotra
- Gastroenterology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
| | - Sunita Singh
- Pathology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
| | - Seema Garg
- Microbiology, BPS Government Medical College for Women, Sonepat, IND
| | - Aparna Parmar
- Microbiology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
| | - Devender Kumar
- Oral Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
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Sahu P, Dayal S, Mawlong PG, Punia P, Sen R. Tinea Corporis Bullosa Secondary to Trichophyton Verrucosum: A Newer Etiological Agent with Literature Review. Indian J Dermatol 2020; 65:76-78. [PMID: 32029951 PMCID: PMC6986116 DOI: 10.4103/ijd.ijd_483_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Priyadarshini Sahu
- Department of Dermatology, Venereology and Leprology, Pt. B D Sharma, University of Health Science, Rohtak, Haryana, India. E-mail:
| | - Surabhi Dayal
- Department of Dermatology, Venereology and Leprology, Pt. B D Sharma, University of Health Science, Rohtak, Haryana, India. E-mail:
| | - Pdiangty Giri Mawlong
- Department of Dermatology, Venereology and Leprology, Pt. B D Sharma, University of Health Science, Rohtak, Haryana, India. E-mail:
| | - Parul Punia
- Department of Microbiology, Pt. B D Sharma, University of Health Science, Rohtak, Haryana, India
| | - Rajeev Sen
- Department of Pathology, Pt. B D Sharma, University of Health Science, Rohtak, Haryana, India
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Good J, Tween H, Howard H, Ma Y, Punia P, Shah T, Mehrzad H, Green S. SABR for Hepatocellular Carcinoma: Efficacy and Toxicity Analysis of a Single-centre Cohort Treated within the NHS England Commissioning through Evaluation Programme. Clin Oncol (R Coll Radiol) 2018. [DOI: 10.1016/j.clon.2018.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Punia P, Goel N, Singh I, Chaudhary U. Occupational CNS aspergillosis in an immunocompetent individual a diagnostic challange. Arch Environ Occup Health 2017; 73:381-384. [PMID: 29283878 DOI: 10.1080/19338244.2017.1411328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/24/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Immunocompetent individuals are rarely affected by Aspergillus species and its prime importance lies in immunocompromised patients where it can cause disease, ranging from primarily pulmonary infections to dissemination anywhere in the body. Invasive aspergillosis (IA) occurs in patients with risk factors including prolonged neutropenia, neutrophil dysfunction, patient on cytotoxic drugs, steroid therapy, hematological malignancy, AIDS or in patients with bone marrow transplantation. A recently documented risk factor for IA is the exposure to environmental aspergillus spores at construction sites which makes it an important public health issue. We report here a case of primary CNS aspergillosis in an immunocompetent person who was initially diagnosed as a case of meningioma, and had a history of working in an area with excessive ongoing construction. He had no other primary focus of infection anywhere in the body. He was timely diagnosed and broad spectrum antifungals were started immediately. MATERIAL AND METHODS The brain biopsy and pus sampleas were subjected to direct microscopy using KOH mount and lactophenol cotton blue (LPCB) stain and culture on Sabourad's Dextrose Agar in Microbiology laboratory. Later patient was started on fluconazole and caspofungin. RESULTS Thin, hyaline, septate hyphae on direct microscopy and growth of Aspergillus flavus on SDA culture were observed. The patient improved only with antifungals, without surgery. DISCUSSION This case study highlights the importance of keeping the differential diagnosis of Aspergillus spp. in mind even in individuals with no immunodeficiency. The immunocompetent individuals have better prognosis and if timely diagnosed, can be treated even without surgery. The prevalence of aspergillus spores at construction and demolition sites makes it an important public health issue, hence precautions must be advocated at these sites.
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Affiliation(s)
- Parul Punia
- a Demonstrator, Department of Microbiology, PGIMS , Rohtak , India
| | - Nidhi Goel
- b Professor, Department of Microbiology, PGIMS , Rohtak , India
| | - Ishwar Singh
- c Senior Professor and Head of the Department, Department of Neurosurgery , PGIMS Rohtak , India
| | - Uma Chaudhary
- c Senior Professor and Head of the Department, Department of Neurosurgery , PGIMS Rohtak , India
- d Senior Professor and Head of the Department, Department of Microbiology , PGIMS Rohtak , India
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Ramage J, Punia P, Faluyi O, Frilling A, Meyer T, Kapur G, Cave J, Wadsley J, Cummins S, Farrugia D, Starling N, Wall L, Saharan R, Valle J. UK phase IV, observational study to assess quality of life in patients (pts) with pancreatic neuroendocrine tumours (pNETS) receiving treatment with everolimus: The “real-world” OBLIQUE study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw369.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Goel N, Rohilla H, Singh G, Punia P. Antifungal Activity of Cinnamon Oil and Olive Oil against Candida Spp. Isolated from Blood Stream Infections. J Clin Diagn Res 2016; 10:DC09-11. [PMID: 27656437 PMCID: PMC5028442 DOI: 10.7860/jcdr/2016/19958.8339] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/14/2016] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Recently non-albicans Candida has emerged as a major cause of morbidity and mortality in blood stream infections. Some species of the Candida are becoming increasingly resistant to first line and second line antifungals such as echinocandins and fluconazole. In view of increasing global antifungal resistance, role of alternative and better antifungals like natural plant products need to be explored. Essential oils are known to exhibit antimicrobial activity against various fungi. Hence, we evaluated the efficacy of cinnamon oil and olive oil against Candida spp. AIM To evaluate the invitro antifungal activity of olive oil and cinnamon oil against blood stream Candida isolates. MATERIALS AND METHODS The present prospective observational study was conducted in the Department of Microbiology at a tertiary care teaching hospital during one year June 2011-July 2012. Blood samples were collected from 1376 patients clinically suspected to have fungal septicaemia, out of which 100 (7.2%) Candida isolates obtained, were speciated by conventional methods. Antifungal susceptibility testing of all the isolates was done against fluconazole, voriconazole as per NCCL (M27-A2) and against olive oil and cinnamon oil by agar well diffusion method. RESULTS Prevalence of Candidemia was 7.26%. C. albicans (85.3%) and C. parapsilosis (85.7%) were most sensitive to fluconazole followed by C. tropicalis (67.4%). All isolates were 100% sensitive to voriconazole. Both oils were found to be effective against nearly 50% of the Candida isolates. About 55.5% of fluconazole resistant C. krusei strains were sensitive to olive and cinnamon oil. CONCLUSION Fluconazole resistant non-albicans Candida has emerged as major cause of Candidemia. Cinnamon and olive oil show marked sensitivity against albicans and non-albicans spp.
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Affiliation(s)
- Nidhi Goel
- Professor, Department of Microbiology, PGIMS, Rohtak, Haryana, India
| | - Hina Rohilla
- Senior Resident, Department of Microbiology, PGIMS, Rohtak, Haryana, India
| | - Gajender Singh
- Senior Professor and Head of the Department, Department of Pharmacy, PGIMS, Rohtak, Haryana, India
| | - Parul Punia
- Senior Resident, Department of Microbiology, PGIMS, Rohtak, Haryana, India
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Sood N, Chaudhary DK, Pradhan PK, Verma DK, Raja Swaminathan T, Kushwaha B, Punia P, Jena JK. Establishment and characterization of a continuous cell line from thymus of striped snakehead, Channa striatus (Bloch 1793). In Vitro Cell Dev Biol Anim 2015; 51:787-96. [DOI: 10.1007/s11626-015-9891-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Accepted: 03/09/2015] [Indexed: 12/31/2022]
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Punia P, Bhardwaj N, Mathur P, Gupta G, Misra MC. Profile of fatal Streptococcal bacteraemia at a tertiary care Indian hospital. Indian J Med Microbiol 2015; 33:148-51. [DOI: 10.4103/0255-0857.148424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lalwani S, Punia P, Mathur P, Trikha V, Satyarthee G, Misra MC. Hospital acquired infections: preventable cause of mortality in spinal cord injury patients. J Lab Physicians 2014; 6:36-9. [PMID: 24695997 PMCID: PMC3969640 DOI: 10.4103/0974-2727.129089] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND There is an alarming rate of morbidity and mortality observed in the trauma victims who suffer spinal cord injuries (SCI). Such patients are admitted immediately and stay for longer periods of time and thus are at risk of acquiring nosocomial infections. AIMS The aim of this study is to analyze the primary cause of mortality in SCI patients. DESIGN Retrospective study. MATERIALS AND METHODS We conducted a retrospective 4 year analysis of the postmortem data of 341 patients who died after sustaining SCI at a tertiary care apex trauma center of India. Epidemiological data of patients including the type of trauma, duration of hospital stay, cause of death and microbiological data were recorded. RESULTS On autopsy, out of 341 patients, the main cause of death in the SCI patients was ascertained to be infection/septicemia in 180 (52.7%) patients, the rest 161 (47.2%) died due to severe primary injury. Respiratory tract infections (36.4%) were predominant followed by urinary tract infections (32.2%), blood stream infections (22.2%), wound infections (7.1%) and meningitis reported in only 5 (2.1%) cases. Acinetobacter sp (40%) was the predominant organism isolated, followed by Pseudomonas sp (16.3%), Klebsiella sp (15.1%), Candida sp (7.8%), Escherichia coli (6.9%), Staphylococcus aureus (6.9%), Proteus sp (3.3%), Enterobacter sp and Burkholderia sp (two cases each) and Stenotrophomonas sp (one case). A high level of multidrug resistance was observed. CONCLUSIONS Hospital acquired infections (HAI) are leading cause of loss of young lives in trauma patients; hence efforts should be made to prevent HAIs.
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Affiliation(s)
- Sanjeev Lalwani
- Department of Forensic, Jai Prakash Narayan Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Parul Punia
- Department of Laboratory Medicine, Jai Prakash Narayan Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Purva Mathur
- Department of Laboratory Medicine, Jai Prakash Narayan Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Trikha
- Department of Orthopedics, Jai Prakash Narayan Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Gurudutta Satyarthee
- Department of Orthopedics, Jai Prakash Narayan Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Mahesh C Misra
- Department of Surgery, Jai Prakash Narayan Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
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Mathur P, Bhardwaj N, Gupta G, Punia P, Tak V, Misra MC. Beta-hemolytic streptococcal infections in trauma patients. Eur J Trauma Emerg Surg 2014; 40:175-81. [PMID: 26815898 DOI: 10.1007/s00068-013-0326-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 08/13/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE β-hemolytic streptococci (βHS) causes a diverse array of human infections. The molecular epidemiology of β-hemolytic streptococcal infections in trauma patients has not been studied. This study reports the molecular and clinical epidemiology of β-hemolytic streptococcal infections at a level 1 trauma centre of India. METHODS A total of 117 isolates of βHS were recovered from clinical samples of trauma patients. The isolates were identified to species level and subjected to antimicrobial susceptibility testing. Polymerase chain reaction (PCR) assay was done to detect exotoxin virulence genes. The M protein gene (emm gene) types of GAS strains were ascertained by sequencing. RESULTS Group A Streptococcus (GAS) was the most common isolate (64 %), followed by group G Streptococcus (23 %). A large proportion of GAS produced speB (99 %), smeZ (91 %), speF (95 %) and speG (87 %). smeZ was produced by 22 % of GGS. A total of 25 different emm types/subtypes were seen in GAS, with emm 11 being the most common. Resistance to tetracycline (69 %) and erythromycin (33 %) was commonly seen in GAS. CONCLUSIONS β-hemolytic streptococcal infections in Indian trauma patients are caused by GAS and non-GAS strains alike. A high diversity of emm types was seen in GAS isolates, with high macrolide and tetracycline resistance. SpeA was less commonly seen in Indian GAS isolates. There was no association between disease severity and exotoxin gene production.
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Affiliation(s)
- P Mathur
- Department of Laboratory Medicine, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - N Bhardwaj
- Department of Laboratory Medicine, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - G Gupta
- Department of Laboratory Medicine, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - P Punia
- Department of Laboratory Medicine, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - V Tak
- Department of Laboratory Medicine, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - M C Misra
- Department of Surgery, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Mathur P, Bhardwaj N, Gupta G, Punia P, Tak V, John NV, Agrawal D, Misra MC. Outbreak of Streptococcus pyogenes emm type 58 in a high dependency unit of a level-1 trauma center of India. Indian J Crit Care Med 2014; 18:77-82. [PMID: 24678149 PMCID: PMC3943131 DOI: 10.4103/0972-5229.126076] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and Aims: Group A Streptococcus (GAS) can cause illnesses ranging from self-limited to severe, life-threatening, invasive infections. The objective of the following study was to investigate a suspected Streptococcus pyogenes outbreak in a high dependency unit (HDU) of our trauma center. Materials and Methods: All the isolates of beta hemolytic Streptococci were identified by standard microbiological methods, Vitek 2 system and latex agglutination tests. Antimicrobial susceptibility testing was performed as recommended by Clinical Laboratory Standards Institute. Exotoxin genes, including speA, speB, speC, speF, smeZ, ssa, speG, speH, speJ, speL, speM and speI were detected by polymerase chain reaction (PCR). The emm types of isolates of S. pyogenes were determined by sequencing the variable 5’ end of emm gene after amplification by PCR. Results: In a 28 bedded poly-trauma ward with a four bedded HDU three out of four patients developed S. pyogenes emm type 58 infection. The strain was macrolide and tetracycline resistant and produced the Streptococcal pyrogenic exotoxins speB, speC, speG, speF and smeZ. Surveillance sampling was done for investigation from patients, health-care workers and environmental samples. Conclusion: An outbreak of GAS infections was established caused by the uncommonly reported emm type 58. The outbreak was controlled by prompt treatment, intensive surveillance, feedback and training.
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Affiliation(s)
- Purva Mathur
- Department of Laboratory Medicine, Microbiology Section, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Nidhi Bhardwaj
- Department of Laboratory Medicine, Microbiology Section, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Gunjan Gupta
- Department of Laboratory Medicine, Microbiology Section, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Parul Punia
- Department of Laboratory Medicine, Microbiology Section, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Vibhor Tak
- Department of Laboratory Medicine, Microbiology Section, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Nibu Varghese John
- Department of Hospital Infection Control, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Deepak Agrawal
- Department of Neurosurgery, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Manesh C Misra
- Department of Surgery, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
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Punia P, Hampton MD, Ridley AM, Ward LR, Rowe B, Threlfall EJ. Pulsed-field electrophoretic fingerprinting of Salmonella indiana and its epidemiological applicability. J Appl Microbiol 2004; 84:103-7. [PMID: 15244064 DOI: 10.1046/j.1365-2672.1997.00325.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Eight Xba I-generated pulsed-field profile (PFP) types and four subtypes within one of the most common PFP types have been identified in Salmonella indiana from patients, poultry and human food in England and Wales in the three-year period from January 1994 to December 1996. Two PFP types have predominated, PFP X1 and PFP X2. Although the PFP X1 type was identified throughout the study period, the PFP X2 type was not identified until late 1995, subsequently becoming the most common PFP type in humans in the first six months of 1996 with a significant distribution in elderly patients. It is concluded that PFGE can be used in support of epidemiological investigations for the subdivision of Salm. indiana. Furthermore, as both conditions and interpretation criteria can be easily standardized, it is suggested that for many salmonella serotypes, PFGE can provide the basis for a definitive scheme of genotypic subtyping suitable for epidemiological investigations at both a national and international level.
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Affiliation(s)
- P Punia
- Laboratory of Enteric Pathogens, Central Public Health Laboratory, London, UK
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Mattick KL, Green J, Punia P, Belda FJ, Gallimore CI, Brown DW. The heteroduplex mobility assay (HMA) as a pre-sequencing screen for Norwalk-like viruses. J Virol Methods 2000; 87:161-9. [PMID: 10856763 DOI: 10.1016/s0166-0934(00)00170-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Molecular epidemiological studies of Norwalk-like viruses (NLVs), previously known as small round structured viruses (SRSVs), are dependant currently on DNA sequencing of PCR amplicons, which is expensive and time consuming. The Heteroduplex Mobility assay (HMA) was evaluated as a method for identification of PCR amplicons from the commonly circulating NLV strains without DNA sequencing. The procedure was developed for use with two reference strains, a Mexico virus-like strain (MXV-like; Hu¿NLV¿RBH¿1993¿UK) and the Grimsby virus strain (Hu¿NLV¿Gimsby¿1995¿UK), and was optimised with regards to the annealing and electrophoresis conditions and the electrophoresis gel matrix. Using the optimised conditions, amplicons of less than 90% sequence identity formed visible heteroduplexes, allowing the strains to be placed into three categories; Mexico-like, Grimsby-like and non-Mexico virus/non-Grimsby virus strains. Outbreak strains 'genotyped' previously by DNA sequencing as Mexico virus or Grimsby virus were identified correctly by the heteroduplex mobility assay. The procedure was applied prospectively to strains from 130 outbreaks occurring in the UK between 1997 and 1998. Heteroduplex mobility assay was successful on 120 (92%) strains of which 68 (57%) were GRV-like strains, three (2.5%) were Mexico virus-like strains and 49 (41%) were categorised as non- Mexico/non-Grimsby virus strains. Amplicons from 50 of the 120 strains were sequenced and there was perfect correlation between the heteroduplex mobility assay categorisation and phylogenetic analysis. HMA offers a rapid, robust and far cheaper alternative to sequencing for the identification of prevalent Norwalk-like virus genotypes for molecular epidemiological studies.
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Affiliation(s)
- K L Mattick
- Regional Virology Laboratory, Leeds Public Health Laboratory, UK
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Rushdy AA, Stuart JM, Ward LR, Bruce J, Threlfall EJ, Punia P, Bailey JR. National outbreak of Salmonella senftenberg associated with infant food. Epidemiol Infect 1998; 120:125-8. [PMID: 9593480 PMCID: PMC2809380 DOI: 10.1017/s0950268897008546] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Eight cases of Salmonella senftenberg infection in infants were identified in the first half of 1995 in England, five were indistinguishable S. senftenberg strains. A case-control study showed an association between illness and consumption of one brand of baby cereal (P = 0.03). The cereal manufacturer reported isolating S. senftenberg in June 1994 from an undistributed cereal batch. Outbreak strains and the cereal strain were all plasmid-free in contrast to other human isolates of S. senftenberg in the same period. Changes in the production process were implemented to prevent further contamination. Surveillance centres should strengthen the detection and investigation of outbreaks of gastrointestinal infection in susceptible groups, especially young children. In this outbreak, the study of only five cases led to identification of the vehicle of infection. Even when few cases are reported, epidemiological investigation in conjunction with molecular typing may lead to public health action which prevents continuing or future outbreaks.
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Affiliation(s)
- A A Rushdy
- Public Health Laboratory Service Communicable Disease Surveillance Centre, London
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Ridley A, Punia P, Ward L, Rowe B, Threlfall E. Plasmid characterization and pulsed-field electrophoretic analysis demonstrate that ampicillin-resistant strains of Salmonella enteritidis phage type 6a are derived from Salm. enteritidis phage type 4. J Appl Microbiol 1996. [DOI: 10.1111/j.1365-2672.1996.tb01962.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ridley AM, Punia P, Ward LR, Rowe B, Threlfall EJ. Plasmid characterization and pulsed-field electrophoretic analysis demonstrate that ampicillin-resistant strains of Salmonella enteritidis phage type 6a are derived from Salm. enteritidis phage type 4. J Appl Bacteriol 1996; 81:613-8. [PMID: 8972088 DOI: 10.1111/j.1365-2672.1996.tb03555.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Plasmid incompatibility studies have demonstrated that strains of Salmonella enteritidis phage type (PT) 6a resistant to ampicillin possess a 36 megadalton incompatibility group (Inc) X plasmid coding for resistance to ampicillin which is capable of converting strains of Salm. enteritidis belonging to PTs 1 and 4 to PT 6a, and PT 8 to PT 13. However, pulsed-field gel electrophoresis (PFGE) has demonstrated that all clinical isolates of PT 6a have a characteristic XbaI pulsed-field profile which is distinct from that of PT 1 and which can only be differentiated from that of PT 4 by the presence of plasmid-associated fragments of less than 45 kb. It is concluded that ampicillin-resistant strains of Salm. enteritidis PT 6a are derived from strains of Salm. enteritidis PT 4 by acquisition of an Inc X ampicillin resistance plasmid.
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Affiliation(s)
- A M Ridley
- Laboratory of Enteric Pathogens, Central Public Health Laboratory, London, UK
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