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Mehra K, Khera D, Didel S, Tak V. Outbreak of Ralstonia pickettii Blood Stream Infection in Pediatric Intensive Care Unit. Indian J Pediatr 2024; 91:636. [PMID: 38095782 DOI: 10.1007/s12098-023-04973-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/29/2023] [Indexed: 05/12/2024]
Affiliation(s)
- Keshav Mehra
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Basni Phase 2, Jodhpur, India
| | - Daisy Khera
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Basni Phase 2, Jodhpur, India.
| | - Siyaram Didel
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Basni Phase 2, Jodhpur, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
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Aggarwal A, Abhishek KS, Tak V, Mehrotra S, Nag VG, Jain V. A Day Saved is a Life Saved: Direct Antimicrobial Susceptibility Testing from Positively Flagged Blood Culture Bottles and their Concordance with the Routine Method. Infect Disord Drug Targets 2024; 24:IDDT-EPUB-139814. [PMID: 38638045 DOI: 10.2174/0118715265280460240302165218] [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: 10/21/2023] [Revised: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Sepsis is a major health problem worldwide and is associated with high morbidity and mortality with every hour delay in initiation of therapy. A conventional method of blood culture and Antimicrobial Susceptibility Testing (AST) takes around 48-72 hours. Empirical antibiotics need to be administered until the sensitivity report is made available. It has been estimated that 20-50% of the empirical antibiotics are inappropriate, resulting in prolonged hospital stays, adverse effects, and emergence of drug resistance. Additionally, this also puts an extra financial burden on both the patients and healthcare settings. Performing direct Antimicrobial Sensitivity Testing (dAST) is an important tool to reduce turn-around time (TAT) by at least 18-24 hours, thus reducing morbidity and mortality among critically ill patients. METHODS Direct AST (dAST) was performed from the positively flagged blood culture bottles received between December, 2021 to May, 2022 from Intensive Care Units (ICUs) on MuellerHinton Agar (MHA) using four drops of withdrawn blood. dAST was performed for six drugs: Ceftriaxone-30 µg (CTR), Piperacillin/Tazobactam-100/10 µg (PIT), Meropenem-10 µg (MRP), Ciprofloxacin-5 µg (CIP), Aztreonam-30 µg (AT), and Colistin (CL). The zone of inhibition was interpreted as per CLSI M100 ed32, 2022 guidelines. A parallel conventional method was also performed to examine for categorical agreement and disagreement. Identification was carried out using MALDI-TOF MS from the colonies that appeared on the dAST plate on the subsequent day. RESULTS A total of 162 positively flagged blood culture bottles were included in the study. The majority of the Gram-negative organisms were from Enterobacterales (n=109), followed by Acinetobacter spp. (n=28) and Pseudomonas aeruginosa (n=25). Out of the 972 isolate-antimicrobial combinations, overall Categorical Agreement (CA) was seen in 936 (96.3%), whereas disagreement was observed in 36 with minor error (mE) in 21 (2.2%), major error (ME) in 7 (0.7%), and very major error (VME) in 8 (0.8%) when compared to the routine method. Categorical agreement (CA) of > 99% was seen in ceftriaxone (CTR) and ciprofloxacin (CIP). In comparison, the lowest CA was observed with meropenem (MRP) at 92%. Colistin dAST was performed using the E-strip method, and the result obtained was highly convincing, with an overall disagreement of only 1.2%. CONCLUSION Rapid dAST from positively flagged blood culture bottles proved to significantly reduce the TAT from the time of sample collection to the first availability of antimicrobial susceptibility report with excellent categorical agreement of > 95% using the conventional disc diffusion method. Results obtained were within the acceptance criteria set by U. S. Food and Drug Administration (FDA) guidelines of > 90% categorical agreement for a new method. We were able to obtain excellent concordance for colistin using the E-strip method. Performing dAST not only saves a "day", but its proper implementation would save a "life".
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Affiliation(s)
- Alisha Aggarwal
- Department of Microbiology, AIIMS, Jodhpur, Rajasthan, India
| | | | - Vibhor Tak
- Department of Microbiology, AIIMS, Jodhpur, Rajasthan, India
| | | | | | - Vidhi Jain
- Department of Microbiology, AIIMS, Jodhpur, Rajasthan, India
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Lodha N, Vihari N, Midha NK, Sethi TK, Garg P, Tak V. Lemierre's Syndrome Caused by Streptococcus pneumoniae in a Patient with Carbimazole-Induced Severe Neutropenia. Kans J Med 2024; 17:22-24. [PMID: 38694169 PMCID: PMC11060776 DOI: 10.17161/kjm.vol17.21217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/23/2024] [Indexed: 05/04/2024] Open
Affiliation(s)
- Naman Lodha
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Nakka Vihari
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Naresh Kumar Midha
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Tashmeen Kaur Sethi
- Department of Intervention and Radiodiagnosis, All India Institute of Medical Sciences, Jodhpur, India
| | - Pawan Garg
- Department of Intervention and Radiodiagnosis, All India Institute of Medical Sciences, Jodhpur, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
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Venugopal S, Chunchanur S, Panigrahy R, Tak V, Yadav M, Chauhan A, Ks H, R J, Pundir S, Bhatt S, Behera B, M S, R A, Chaudhuri S, Mohapatra S. Changes in antimicrobial resistance of Escherichia coli isolated from community associated urinary tract infection before and during the COVID-19 pandemic in India. J Glob Antimicrob Resist 2024:S2213-7165(24)00050-X. [PMID: 38458537 DOI: 10.1016/j.jgar.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/01/2024] [Accepted: 02/22/2024] [Indexed: 03/10/2024] Open
Abstract
PURPOSE Impact of COVID-19 pandemic on antimicrobial resistance (AMR) is largely studied in healthcare settings, there is a need to understand the fluctuations in AMR during pandemic at the community level. Urinary tract infection (UTI) being one of the most common infections in the community, AMR profile of Community-acquired UTI (CA-UTI) is considered representative AMR at the community level. PATIENTS AND METHODS The study was taken in cohort of patients with clinical diagnosis of CA-UTI. The four study sites represented different community health centres in India. Escherichia coli (E.coli) isolates were analysed phenotypically and genotypically for AMR during Pre-COVID (Oct 2019- Feb 2020), 1st wave (Mar 2020 - Feb 2021) and 2nd wave of COVID-19 (Mar 2021- Dec 2021). RESULTS E. coli was the predominant uropathogen (229, 82%) . Increased susceptibility to nitrofurantoin was observed during pandemic. Reduced susceptibility to first line oral antibiotics and carbapenems was seen during 2nd wave. Increased MIC50 to beta-lactams and fluoroquinolones was seen during pandemic. Genomic analysis of E. coli isolates showed some AMR genes {aacC1, aacC4, SHV, QepA} only during 2nd wave. CONCLUSION The good impact of pandemic was evidenced by increased susceptibility to nitrofurantoin. The significant decrease in susceptibility to oral antibiotics during 2nd wave and increased MIC50 of few antibiotics are the bad impact. Decreased susceptibility to last-resort carbapenems and occurrence of various AMR genes only during 2nd wave of pandemic are of great concern and are the ugly impact of pandemic on AMR.
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Affiliation(s)
- Shwetha Venugopal
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Sneha Chunchanur
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | | | - Vibhor Tak
- Department of Microbiology, AIIMS, Jodhpur, India
| | - Manish Yadav
- Translational Health Science and Technology Institute, Faridabad, India
| | - Akanksha Chauhan
- Translational Health Science and Technology Institute, Faridabad, India
| | - Himabindhu Ks
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Jayapriya R
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Swati Pundir
- Department of Microbiology, AIIMS, New Delhi, India
| | | | - Birasen Behera
- Department of Microbiology, SUM Hospital, Bhubaneswar, India
| | - Sumanth M
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Ambica R
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Susmita Chaudhuri
- Translational Health Science and Technology Institute, Faridabad, India.
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Jalootharia G, Sivakumar H, Soni B, Tak V, Agrawal H, Gonnade NM, Gaur R, Kumar D. An uncommon case of a fleeting rash from Western Rajasthan. Trop Parasitol 2024; 14:54-56. [PMID: 38444790 PMCID: PMC10911184 DOI: 10.4103/tp.tp_64_23] [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] [Received: 12/13/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 03/07/2024] Open
Abstract
A 35 year old farmer presented with an erythematous serpiginous rash on dorsal aspect of left foot with intense pruritus and a feeling of something moving slowly in the rash. The photo of the rash is presented below and the case is discussed further.
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Affiliation(s)
| | | | - Bhavesh Soni
- Department of Microbiology, AIIMS, Jodhpur, Rajasthan, India
| | - Vibhor Tak
- Department of Microbiology, AIIMS, Jodhpur, Rajasthan, India
| | - Himanshu Agrawal
- Department of Physical Medicine and Rehabilitation, AIIMS, Jodhpur, Rajasthan, India
| | | | - Ravi Gaur
- Department of Physical Medicine and Rehabilitation, AIIMS, Jodhpur, Rajasthan, India
| | - Deepak Kumar
- Department of General Medicine, AIIMS, Jodhpur, Rajasthan, India
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Mohammad N, Tak V, Bohra GK, Gadepalli R, Sharma A, Singh K, Nag VL. Molecular appraisal of Giardia intestinalis from Western India: A prospective observational study. Trop Parasitol 2024; 14:36-44. [PMID: 38444794 PMCID: PMC10911180 DOI: 10.4103/tp.tp_44_23] [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] [Received: 07/18/2023] [Revised: 10/24/2023] [Accepted: 11/03/2023] [Indexed: 03/07/2024] Open
Abstract
Background Giardia intestinalis is an intestinal protozoan which commonly causes parasitic gastroenteritis globally. It is a species complex consisting of at least eight assemblages (genotypes). In India, Giardia is mostly underreported and missed in asymptomatic cases. Aim The aim of this study was to genotype the G. intestinalis isolates from stool samples of patients at a tertiary care center in Rajasthan, India, and to clinically correlate it. Methods This prospective pilot cross-sectional study was conducted from 2019 to 2021 in a tertiary care center in western India. Patients who were microscopically positive for giardiasis were enrolled. DNA was extracted from their stool samples and amplified by polymerase chain reaction (PCR) using 4E1-HP as the target sequence. Anthropometric measurements and analysis were done for children by using Anthrocal application. Results A total of 50 patients were enrolled. Diarrhea was present in 18 patients (36%). Among these, 6 were immunocompromised and had different comorbidities. Among the children <12 years of age, 55.17% (n = 16/29) were stunted (<-2 S.D.), and among <5 years, 44.4% (n = 4/9) showed wasting (<-2 S.D.). A PCR product corresponding to assemblage B of G. intestinalis was amplified in 47 stool specimens. Only three stool samples were negative for both assemblages A and B and posed an interesting enigma. Conclusion In this study, a predominance of assemblage B of G. intestinalis was detected in 94% of the isolates. Furthermore, the possibility of zoonotic transmission could not be ruled out.
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Affiliation(s)
- Naila Mohammad
- Department of Microbiology, AIIMS, Jodhpur, Rajasthan, India
| | - Vibhor Tak
- Department of Microbiology, AIIMS, Jodhpur, Rajasthan, India
| | | | | | - Anuradha Sharma
- Department of Microbiology, AIIMS, Jodhpur, Rajasthan, India
| | - Kuldeep Singh
- Department of Paediatrics, AIIMS, Jodhpur, Rajasthan, India
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Sharma K, Tak V, Nag VL, Bhatia PK, Kothari N. An observational study on carbapenem-resistant Enterobacterales (CRE) colonisation and subsequent risk of infection in an adult intensive care unit (ICU) at a tertiary care hospital in India. Infect Prev Pract 2023; 5:100312. [PMID: 37868258 PMCID: PMC10585280 DOI: 10.1016/j.infpip.2023.100312] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 02/26/2023] [Indexed: 10/24/2023] Open
Abstract
Background Carbapenem-resistant Enterobacterales (CRE) are a global health problem with a growing prevalence. India has a high prevalence of CRE. CRE infections are difficult to treat, and are associated with significant morbidity and mortality. Colonisation is generally a prerequisite for infection and the prevention of CRE colonisation is key to the prevention of CRE infection. Objectives To determine the prevalence of CRE colonisation and subsequent infections in an adult intensive care unit (ICU) in India. Methods We conducted a prospective observational study in which perirectal swabs were obtained along with relevant clinical details of consenting adult patients upon ICU admission between January 2019 and August 2020. Rectal screening was performed using MacConkey agar plates with ertapenem disks and further identification was performed using conventional microbiological techniques. Ertapenem minimum inhibitory concentration (MIC) was determined using an epsillometer (E) test. The modified carbapenem inactivation (mCIM) test and EDTA carbapenem inactivation test (eCIM) were performed to confirm carbapenem resistance using the Clinical Laboratory Standards Institute (CLSI) 2020 guidelines. Results 192 ICU patients were screened for CRE. 37 patients were found to be colonised with CRE. Klebsiella pneumoniae (N=25; 67.6%) was the most frequent CRE isolate, followed by Escherichia coli (N=11; 29.7%) and one Enterobacter species (N=1; 2.7%). 89.2% (33/37) patients developed CRE infection. Pneumonia was the most common CRE infection identified in 12/33 (36.4%) patients.during the hospital stay. The median duration of hospital stay was longer (17 days) for CRE colonised compared to CRE non-colonised patients (9 days) (P<0.001). Death occurred in 27 % (N=10/37) of CRE-colonised patients during the hospital admission. Conclusion CRE colonisation is associated with high risk of subsequent CRE infection and longer ICU and hospital admission.
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Affiliation(s)
- Kirtika Sharma
- All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Vibhor Tak
- All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Vijaya Lakshmi Nag
- All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | | | - Nikhil Kothari
- All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
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Meena DS, Kumar D, Meena V, Bohra GK, Tak V, Garg MK. Epidemiology, clinical presentation, and predictors of outcome in nontuberculous mycobacterial central nervous system infection: a systematic review. Trop Med Health 2023; 51:54. [PMID: 37749661 PMCID: PMC10518932 DOI: 10.1186/s41182-023-00546-4] [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: 06/14/2023] [Accepted: 09/16/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND CNS manifestations represent an emerging facet of NTM infection with significant mortality. Due to protean presentation and low index of suspicion, many cases are often treated erroneously as tubercular meningitis or fungal infections. OBJECTIVES Literature on NTM CNS disease is scarce, with most available data on pulmonary disease. This systematic review aimed to evaluate the epidemiology, clinical presentation, diagnostic modalities, and predictors of outcome in CNS NTM infection. METHODS The literature search was performed in major electronic databases (PubMed, Google Scholar, and Scopus) using keywords "CNS," "Central nervous system," "brain abscess," "meningitis," "spinal," "Nontuberculous mycobacteria," "NTM". All cases of CNS NTM infection reported between January 1980 and December 2022 were included. RESULTS A total of 77 studies (112 cases) were included in the final analysis. The mean age of all patients was 38 years, with most patients male (62.5%). Mycobacterium avium complex (MAC) was the most common aetiology, followed by M. fortuitum and M. abscessus (34.8%, 21.4% and 15.2%, respectively). The disseminated disease was found in 33% of cases. HIV (33.9%) and neurosurgical hardware (22.3%) were the common risk factors. Intracranial abscess (36.6%) and leptomeningeal enhancement (28%) were the most prevalent findings in neuroimaging. The overall case fatality rate was 37.5%. On multivariate analysis, male gender (adjusted OR 2.4, 95% CI 1.2-7.9) and HIV (adjusted OR 3.7, 95% CI 1.8-6.1) were the independent predictors of mortality). M. fortuitum infection was significantly associated with increased survival (adjusted OR 0.18, 95% CI (0.08-0.45), p value 0.012). CONCLUSIONS Current evidence shows the emerging role of rapid-grower NTM in CNS disease. Male gender and HIV positivity were associated with significant mortality, while M fortuitum carries favourable outcomes.
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Affiliation(s)
- Durga Shankar Meena
- Department of Internal Medicine (Division of Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India.
| | - Deepak Kumar
- Department of Internal Medicine (Division of Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Vasudha Meena
- Department of Pediatrics, Dr. S.N. Medical College, Jodhpur, 342005, India
| | - Gopal Krishana Bohra
- Department of Internal Medicine (Division of Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Mahendra Kumar Garg
- Department of Internal Medicine (Division of Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
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Vihari N, Bohra GK, Yadev RR, Kumar D, Meena DS, Tak V, Sharma A, Nag V, Garg MK. The emergence of multidrug-resistant Gram-positive bloodstream infections in India - a single center prospective cohort study. Germs 2023; 13:229-237. [PMID: 38146377 PMCID: PMC10748842 DOI: 10.18683/germs.2023.1389] [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: 11/16/2022] [Revised: 05/19/2023] [Accepted: 08/05/2023] [Indexed: 12/27/2023]
Abstract
Introduction Gram-positive bloodstream infections (BSIs) are an emerging health concern, especially in resource-limited settings. There is a paucity of data regarding the antimicrobial resistance (AMR) pattern of Gram-positive BSIs. The rise in multidrug-resistant infections further convoluted antibiotic selection. We aimed to assess the incidence, clinical and microbiological profile, antimicrobial resistance (AMR) and outcome in Gram-positive BSIs. Methods This was a single-center prospective study conducted at a tertiary care hospital in Western India. All patients (age ≥18 years) with culture-proven Gram-positive BSIs were included. Data were collected on all patients' demography, risk factors, AMR and clinical outcome. Results A total of 210 clinically significant isolates were grown from July 2020 to December 2021. The incidence of Gram-positive BSIs was 29% (n=61); 55.9% of cases were healthcare-associated, while 44.1% were community-acquired. Coagulase-negative staphylococci (CoNS) were the major isolates (36.1%), followed by Enterococcus spp. (27.9%), methicillin-susceptible Staphylococcus aureus (MSSA) (18%) and methicillin-resistant Staphylococcus aureus (MRSA) (14.7%). The proportion of vancomycin and teicoplanin-resistant CoNS isolates was 13.6% and 19%. Among Enterococcus isolates, the proportion of vancomycin-resistant enterococci (VRE) and linezolid-resistant enterococci (LRE) were 11.8% and 5.9%. The overall mortality in Gram-positive BSIs was 42.6%. Older age, MRSA infection, septic shock, and high NLR were significantly associated with mortality. On the Cox regression model, age ≥65 years (HR: 2.5; 95%CI: 1.1-5.8; p=0.024) and MRSA infection (HR: 3.6; 95%CI: 1.5-8.5; p=0.021) were found as independent predictors of 30-day mortality. Conclusions This study found substantial mortality with Gram-positive BSIs, especially MRSA infections. Moreover, the emergence of VRE and LRE is also alarming. Active surveillance of AMR and evaluation of mortality predictors may help overcome the therapeutic challenges in managing BSIs.
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Affiliation(s)
- Nakka Vihari
- MD, Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Gopal Krishana Bohra
- MD, Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Ram Ratan Yadev
- MS, Department of General Surgery, S.K. Medical College, Sikar, India
| | - Deepak Kumar
- MD, Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Durga Shankar Meena
- MD, Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Vibhor Tak
- MD, Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Ankur Sharma
- MD, Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, India
| | - Vijaylaxmi Nag
- MD, Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Mahendra Kumar Garg
- DM, Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India
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P N, Kumar D, Meena DS, R NT, Bohra GK, Tak V, Sharma A, Midha NK, Garg MK. Difficult-to-treat resistant gram-negative blood stream infections - the beginning of a superbug era - a prospective observational study. Indian J Med Microbiol 2023; 44:100364. [PMID: 37356828 DOI: 10.1016/j.ijmmb.2023.02.007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/22/2023] [Accepted: 02/19/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Carbapenem resistant gram-negative bacterial infections are a growing concern worldwide. However, India is already in the era of a shortage of effective antibiotics for the management of these infections. Moreover, Difficult-to-Treat Resistance (DTR) gram-negative infections, which are not much studied, further complicate the scenario. This study emphasized the incidence and outcomes of DTR infections. METHODOLOGY This is a single-center prospective observational study. The study included hospitalised patients aged ≥18 years with gram-negative bacterial bloodstream infections (GNBSI). Blood cultures with the growth of contaminants and/or single positive culture taken from the femoral site were excluded. Incidences of DTR infections and outcomes in the form of 30-day mortality were analysed. RESULTS Two hundred forty patients with GNBSI episodes were recorded. The Incidence of DTR GNBSI was 37.9% (91/240). Multivariate analysis found that Hospital-acquired infections, ICU admission and mechanical ventilation were independent risk factors for DTR GNBSI. The most common DTR GNB isolates were Klebsiella pneumoniae (31/49, 63.3%) and Acinetobacter baumannii (26/52, 50%). The adjusted relative risk of mortality was remarkably high in DTR GNBSI (aRR 3.9; 95% CI 1.9-7.9) as compared to CR+/DTR- GNBSI (aRR 0.3; 95% CI 0.1-1.0) and ESCR/CS GNBSI (aRR 1.1; 95% CI 0.5-2.4). CONCLUSION DTR GNB infections are growing concern in India and this need to be evaluated in multicentric studies. Moreover, DTR GNBSI was associated with significantly higher mortality and there is need of further empowerment of antibiotic stewardship practices.
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Affiliation(s)
- Naveenraj P
- Department of General Medicine and Infectious Diseases, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Deepak Kumar
- Department of General Medicine and Infectious Diseases, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Durga Shankar Meena
- Department of General Medicine and Infectious Diseases, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Neetha T R
- Department of General Medicine and Infectious Diseases, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Gopal Krishana Bohra
- Department of General Medicine and Infectious Diseases, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Ankur Sharma
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Naresh Kumar Midha
- Department of General Medicine and Infectious Diseases, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Mahendra Kumar Garg
- Department of General Medicine and Infectious Diseases, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
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Shrimali T, Malhotra S, Relhan N, Tak V, Choudhary SK, Gupta N, Singh AK. Streptococcus parasanguinis: An emerging pathogen causing neonatal endocarditis: A case report. Access Microbiol 2023; 5:acmi000576.v4. [PMID: 37424549 PMCID: PMC10323779 DOI: 10.1099/acmi.0.000576.v4] [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] [Received: 02/02/2023] [Accepted: 06/13/2023] [Indexed: 07/11/2023] Open
Abstract
Background. The microbial infection of the endocardium, popularly known as Infective Endocarditis (IE), is typically classified on the basis of anatomy, valve nativity and its associated microbiology. As per the associated microbiology, Staphylococcus aureus is the most common microorganism responsible for the cause of IE. Even though, the Streptococcus group accounts for a smaller percentage of IE, however this doesn't give us the liberty of ignoring the high mortality and morbidity associated with this pathogen. Case presentation. We report an unusual case of neonatal sepsis, complicated with endocarditis, caused by penicillin resistant Streptococcus parasanguinis . The neonate however died of the same despite all efforts. The said baby was given birth by a mother with gestational diabetes mellitus. Conclusion High index of clinical suspicion and prompt diagnosis are the most important factors of patient management, especially in cases of life threatening neonatal infections. In such conditions a coordinated interdepartmental approach is very much needed.
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Affiliation(s)
- Twishi Shrimali
- Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan
| | - Shikhir Malhotra
- Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan
| | - Nidhi Relhan
- Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan
| | - Vibhor Tak
- Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan
| | | | - Neeraj Gupta
- Neonatology, All India Institute of Medical Sciences, Jodhpur, Rajathan
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Chaudhary R, Tak V, Dutt A, Rodha MS, Meena SP, Badkur M, Kobade SP, Lodha M, Sharma N, Nag VL, Puranik A. Current Trends in the Management of Port-Site Infections: A Case Series and a Review of Published Work. Cureus 2023; 15:e40936. [PMID: 37496535 PMCID: PMC10368301 DOI: 10.7759/cureus.40936] [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: 06/25/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction Laparoscopic techniques have become standard for many surgeries, offering benefits such as quicker recovery and less pain. However, port-site infections (PSIs) can occur and pose challenges. PSIs can be early (within seven days) or delayed (after three to four weeks), with delayed PSIs often caused by non-tuberculous mycobacteria (NTMs). NTMs are difficult to treat and do not respond well to antibiotics, leading to prolonged and recurrent infections. Guidelines for PSI management are limited. This summary highlights a case series of 10 patients with PSIs, discussing their treatment experience and presenting a treatment algorithm used at our institute. Methods This is a retrospective study (2015-2020) on chronic port-site infections (PSIs) in laparoscopic surgeries. Data were collected on patient demographics, surgery type, prior treatment, and management at the institute. Results The study analyzed 10 patients with chronic PSIs following laparoscopic surgery between 2015 and 2020. Laparoscopic cholecystectomy was the most frequent index surgery. Three patients had a history of treatment with varying durations of anti-tubercular therapy, one of whom had completed anti-tubercular treatment prior to presentation. Complete surgical excision with histopathological examination and fungal, bacterial and mycobacterial cultures were performed. Seven of the 10 patients were treated with oral ciprofloxacin and clarithromycin combination therapy for three months, two were treated with culture-based antibiotics and one was treated with anti-tubercular therapy. All patients improved on treatment. The mean follow-up period was 52 ± 9.65 months, with no relapses being reported. Conclusion Port-site infections (PSIs) are troublesome complications of laparoscopic surgery that can erode the benefits of the procedure. Delayed PSIs caused by drug-resistant mycobacteria are difficult to treat. Improved sterilization methods and thorough microbiological work-up are crucial. Radical excision and prolonged oral antibiotics are effective treatments. Clinicians should avoid empirical antibiotic therapy to prevent antimicrobial resistance.
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Affiliation(s)
- Ramkaran Chaudhary
- General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Vibhor Tak
- Microbiology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Akshat Dutt
- General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Mahaveer S Rodha
- General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Satya Prakash Meena
- General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Mayank Badkur
- General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Sarika P Kobade
- Microbiology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Mahendra Lodha
- General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Naveen Sharma
- General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Vijaya L Nag
- Microbiology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Ashok Puranik
- General Surgery, All India Institute of Medical Sciences, Guwahati, Guwahati, IND
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Chhakchhuak M, Chaturvedy M, Agarwal J, Tak V, Bajpai NK. Retrospective Analysis of Spectrum of Infections and Antibiotic Resistance Pattern in Chronic Kidney Disease Patients on Maintenance Hemodialysis in a Tertiary Care Centre in North India. Indian J Nephrol 2023; 33:177-182. [PMID: 37448889 PMCID: PMC10337228 DOI: 10.4103/ijn.ijn_238_21] [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] [Received: 06/07/2021] [Revised: 08/03/2021] [Accepted: 10/25/2021] [Indexed: 07/15/2023] Open
Abstract
Introduction Hemodialysis patients are at risk of infections. This study examines the spectrum of infections and antibiotic resistance patterns. Methods We retrospectively reviewed the records of 586 hemodialysis patients from May 2018 to April 2020 in a tertiary care hospital in North India. Results The study identified 99 episodes of confirmed infections. Urinary tract infections were the most common type of infections (55.5%), followed by catheter-related bloodstream infections (CRBSI) (definitive 21.2%). Other infections were pneumonia (8.1%), tuberculosis (6.1%), skin and soft tissue infection (4.0%), dengue fever (3.03%), and empyema thoracis (1.0%). Overall, Escherichia coli (33.3%) was the most common organism isolated. The most frequent uropathogens recovered were Escherichia coli (54%). In confirmed CRBSI, P. aeruginosa (23.8%) and MSSA (23.8%) were the most common pathogen isolated. K. pneumonia (37.5%) was the most common pathogen in pneumonia. Uropathogens showed the highest resistance to fluoroquinolones (93.3%-100%). Pathogens isolated in CRBSI showed maximum resistance to ciprofloxacin (100%). In pneumonia, the highest resistance was seen to third-generation cephalosporins (75%-100%). Conclusion Though the bacterial spectrum remains the same over time, antibiotic resistance is changing in uropathogens. There is a trend of predominance of Gram-negative bacterial infections in CRBSI. Tuberculosis incidence rate was much higher than the general population. There is a need for nationwide and worldwide continuous surveillance.
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Affiliation(s)
- Malsawmkima Chhakchhuak
- Department of Nephrology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Manish Chaturvedy
- Department of Nephrology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Jony Agarwal
- Department of Nephrology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Nitin K. Bajpai
- Department of Nephrology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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14
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Kalita JM, Sharma K, Mohammad N, Tak V, Mittal A, Nag VL. Refractory giardiasis in a child with steroid-resistant nephrotic syndrome. Access Microbiol 2023; 5:000476.v3. [PMID: 37223065 PMCID: PMC10202400 DOI: 10.1099/acmi.0.000476.v3] [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] [Received: 08/13/2022] [Accepted: 02/14/2023] [Indexed: 05/25/2023] Open
Abstract
Giardiasis is an infection of the small intestine caused by the protozoan parasite Giardia intestinalis and one of the most common parasitic intestinal diseases in humans worldwide. It mainly manifests as a self-limited illness in the case of immunocompetent patients and usually does not require treatment. However, immunodeficiency is a risk factor for the onset of severe Giardia infection. In this report, a case of recurrent giardiasis refractory to nitroimidazole therapy is presented. A 7-year-old male patient with steroid-resistant nephrotic syndrome came to our hospital because of chronic diarrhoea. The patient was on long-term immunosuppressive therapy. Microscopic examination of stool showed a significant number of trophozoites and cysts of G. intestinalis. Treatment with metronidazole for longer duration than recommended has failed to clear the parasite in the present case.
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Affiliation(s)
- Jitu Mani Kalita
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, Pin-342005, India
| | - Kirtika Sharma
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, Pin-342005, India
| | - Naila Mohammad
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, Pin-342005, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, Pin-342005, India
| | - Aliza Mittal
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, Pin-342005, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, Pin-342005, India
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Mohapatra S, Ghosh D, Vivekanandan P, Chunchanur S, Venugopal S, Tak V, Panigrahy R, Chaudhuri S, Pundir S, Sharma T, Kocher D, Singh H, Gautam H, Sood S, Das BK, Kapil A, Kumar A, Kumari R, Kalaivani M, Rangaiah A, Salve HR, Malhotra S, Kant S, Hari P. Genome profiling of uropathogenic E. coli from strictly defined community-acquired UTI in paediatric patients: a multicentric study. Antimicrob Resist Infect Control 2023; 12:36. [PMID: 37072773 PMCID: PMC10114455 DOI: 10.1186/s13756-023-01233-z] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/22/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Urinary tract infection (UTI) in children is a common bacterial infection. The emergence of extended-spectrum beta-lactamases (ESBLs) poses a major challenge against the treatment of uropathogens. We aimed to characterize the E. coli isolates recovered from children with UTI for their resistance profile and circulating sequence types (ST). METHODS Children (> 1.5-18 years of age) from different community health centres of India with symptoms of UTI were enrolled. Isolates causing significant bacteriuria were identified by Matrix-Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) and tested for antimicrobial susceptibility by the automated system, VITEK-2 (Biomeriux, Durhum, US). Nineteen E. coli isolates (15 ESBL positive and 4 ESBL negative) were sequenced in Oxford Nanopore platform followed by core-genome phylogeny, accessory genome cluster analysis, identification of sequence types, mobile genetic elements, genetic antimicrobial resistance markers. The correlation between detection of antimicrobial resistance genes with phenotypic resistance profiles was also investigated. RESULTS Eleven percent of children had significant bacteriuria [male:female-1:1, > 50% were 11-18 years of age group]. E. coli was predominant (86%) followed by K. pneumoniae (11%). Susceptibility of E. coli was highest against fosfomycin (100%) followed by carbapenems (90.7%) and nitrofurantoin (88.8%). ST131 (15.8%) and ST167 (10.5%) found as high-risk clones with the presence of plasmid [IncFIB (63.1%), IncFIA (52.6%)], and composite transposon [Tn2680 (46.6%)] in many isolates. Few isolates coharboured multiple beta-lactamases including blaNDM-5 (33.3%), blaOXA-1 (53.3%), blaCTX-M-15 (60%) and blaTEM-4 (60%). CONCLUSIONS This study highlights horizontal transmission of resistance genes and plasmids in paediatric patients at community centers across the nation harbouring multidrug-resistant genes such as blaNDM-5 and blaCTX-M-15 associated with high-risk clones ST131 and ST167. The data is alarming and emphasizes the need for rapid identification of resistance markers to reduce the spread in community. To our knowledge, this is the first multicentric study targeting paediatric UTI patients from the community setting of India.
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Affiliation(s)
| | - Dipannita Ghosh
- Kusuma School of Biological Sciences, Indian Institute of Technology Delhi, New Delhi, India
| | - Perumal Vivekanandan
- Kusuma School of Biological Sciences, Indian Institute of Technology Delhi, New Delhi, India
| | - Sneha Chunchanur
- Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, India
| | - Shwetha Venugopal
- Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, India
| | - Vibhor Tak
- Department of Microbiology, AIIMS, Jodhpur, India
| | | | - Susmita Chaudhuri
- Translational Health Science and Technology Institute, Faridabad, India
| | - Swati Pundir
- Department of Microbiology, AIIMS, New Delhi, India
| | - Tanya Sharma
- Department of Biomedical Informatics, ICMR, New Delhi, India
| | | | - Harpreet Singh
- Department of Biomedical Informatics, ICMR, New Delhi, India
| | | | - Seema Sood
- Department of Microbiology, AIIMS, New Delhi, India
| | | | - Arti Kapil
- Department of Microbiology, AIIMS, New Delhi, India
| | | | - Rajesh Kumari
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | | | - Ambica Rangaiah
- Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, India
| | | | | | - Shashi Kant
- Centre for Community Medicine, AIIMS, New Delhi, India
| | - Pankaj Hari
- Department of Paediatrics, AIIMS, New Delhi, India
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Sharma K, Srivastava S, Tak V. Cryptosporidiosis in India and the World: A review. Infect Disord Drug Targets 2023; 23:IDDT-EPUB-130656. [PMID: 37016532 DOI: 10.2174/1871526523666230403103344] [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: 08/09/2022] [Revised: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 06/19/2023]
Abstract
Cryptosporidiosis is caused by infection with a coccidian parasite belonging to the genus Cryptosporidium. Initially, human cryptosporidiosis was believed to be caused only by one species, but since the advent of molecular studies, 15 more species have been discovered to cause this infection. Among them, Cryptosporidium hominis and Cryptosporidium parvum are the most common species involved. This mainly affects children and causes diarrhea in most cases. It is mainly diagnosed by microscopy, especially in low-middle-income countries. This review covers the epidemiology, life cycle, risk factors, clinical manifestations, different diagnostic methods and treatment of this disease.
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Affiliation(s)
- Kirtika Sharma
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Saumya Srivastava
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
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17
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Katyal S, Srivastav S, Katoch O, Rodrigues C, Rupali P, Chakrabarti A, Ray P, Biswal M, Tak V, Nath R, Mukhopadhyay C, Bhattacharya S, Padmaja K, Deotale V, Venkatesh V, Wattal C, Ma T, Nag VL, Ray R, Behera B, Baveja S, Karuna T, Singh SK, Fomda B, Devi SK, Das P, Khandelwal N, Verma P, Thangavelu P, Nazir S, Eshwara VK, Varma M, Mishra TS, Das RR, Malhotra R, Walia K, Guleria R, Mathur P. A self-reported survey on the implementation of infection prevention and control elements in Indian hospitals, part of a HAI surveillance network: Results from 23 hospitals conducting a standardized IPC assessment. Am J Infect Control 2023; 51:29-34. [PMID: 35577058 DOI: 10.1016/j.ajic.2022.04.014] [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: 12/08/2021] [Revised: 04/14/2022] [Accepted: 04/14/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Healthcare-associated infections (HAIs) are one of the most common adverse events in patient care that account for substantial morbidity and mortality. We evaluate the existing Infection Prevention and Control (IPC) practices in hospitals participating in the nationally representative HAI Surveillance network. METHODS This cross-sectional survey was conducted in 23 hospitals across 22 states of India from October-2015 to September-2018 in the HAI surveillance network. The World Health Organization (WHO) IPC core components assessment tool for health-care facility level (IPCAT-H) was adapted from IPC assessment tool developed by US Centers for Disease Control and Prevention (US CDC) under the Epidemiology and Laboratory Capacity (ELC) Infection Control Assessment and Response (ICAR) Program. Mann-Whitney U test was used to calculate the significant difference between scores (P < .05). RESULTS Amongst the participating hospitals, 7 were private sectors and 16 were public health care facilities. Infection IPCAT-H average score per multimodal strategy was less than 50% for programmed IPC activities (45.7); implementation of health care workers (HCWs) immunization programme (43.5%); monitoring and evaluation component (38.30%). CONCLUSIONS There is potential for improvement in Human Resources, Surveillance of HAIs as well as Monitoring and Evaluation components.
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Affiliation(s)
- Sonal Katyal
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Sharad Srivastav
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Omika Katoch
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Camilla Rodrigues
- Department of Microbiology, P. D. Hinduja Hospital and Medical Research Center, Mumbai, Maharashtra, India
| | - Priscilla Rupali
- Departments of Infectious Diseases, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Arunaloke Chakrabarti
- Department of Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Pallab Ray
- Department of Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Manisha Biswal
- Department of Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Reema Nath
- Department of Microbiology, Assam Medical College, Assam, India
| | | | - Sanjay Bhattacharya
- Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
| | - Kanne Padmaja
- Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Vijayshri Deotale
- Department of Microbiology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | - Vimala Venkatesh
- Department of Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Chand Wattal
- Departments of Clinical Microbiology and Immunology, Sir Ganga Ram Hospital, New Delhi, India
| | - Thirunarayan Ma
- Department of Microbiology, Apollo Hospital, Chennai, Tamil Nadu, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Raja Ray
- Department of Microbiology, Institute of Post-Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Bijayini Behera
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sujata Baveja
- Department of Microbiology, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
| | - Tadepalli Karuna
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh
| | - Sanjeev K Singh
- Department of Infection Control, Amrita Institute of Medicine Sciences, Amrita University, Kochi, Kerala, India
| | - Bashir Fomda
- Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Sulochana K Devi
- Department of Microbiology, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Padma Das
- Department of Microbiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Neeta Khandelwal
- Department of Microbiology, Government Medical College, Surat, Gujarat, India
| | - Prachi Verma
- Department of Critical Care Medicine, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, India
| | - Premkumar Thangavelu
- Departments of Infectious Diseases, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Shaista Nazir
- Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Vandana K Eshwara
- Department of Microbiology, Kasturba Medical College, Manipal, Karnataka, India
| | - Muralidhar Varma
- Department of Infectious Diseases, Kasturba Medical College, Manipal, Karnataka, India
| | - Tushar S Mishra
- Department of General Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rashmi R Das
- Department of Paediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rajesh Malhotra
- Department of Orthopedics, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Kamini Walia
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Randeep Guleria
- Department of Pulmonary Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Purva Mathur
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India.
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Sharma K, Srivastava S, Kundu A, Tak V. Detection of Antibodies against Toxoplasma from Human Serum Sample using ELISA. Infect Disord Drug Targets 2023; 23:89-91. [PMID: 36100992 DOI: 10.2174/1871526522666220913152447] [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: 05/17/2022] [Revised: 06/29/2022] [Accepted: 07/21/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Toxoplasmosis is a common worldwide zoonotic infection affecting warm blooded animals and humans caused by Toxoplasma gondii. Clinical features range from mildfebrile illness and lymphadenopathy in the immunocompetent host to encephalitisin the immunosuppressed host (E.g. HIV infected patients). Congenital infection can also occur. For effective control and treatment of toxoplasmosis, accurate detection of T. gondii infection is important. OBJECTIVE In this study, ELISA detecting anti-toxoplasma antibodies IgM and IgG has been used for diagnosing Toxoplasmosis in patients. METHODS Enzyme-linked immunosorbentassay (ELISA) was carried out in serum samples collected from 40 patients to detect anti-toxoplasma IgG and IgM antibodies as a part of work up in suspected cases. Relevant clinical history was also taken. RESULTS Of the total 40 samples taken, only one sample came positive for IgM and 9 came positive for IgG antibody. All patients who were seropositivefor T. gondii antibodies had HIV infection. Five patients were in the age group between 30 to 40 years. CONCLUSION From the limited data available in this study, it may be recommended to screen for T. gondii antibodies in HIV patients.
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Affiliation(s)
- Kirtika Sharma
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Saumya Srivastava
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Aditya Kundu
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
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Shrimali T, Srivastava S, Mohammad N, John N, Tak V, Saxena R. Giardiasis in an Infant With Fibrosarcoma: A Case Report. Infect Disord Drug Targets 2023; 23:82-85. [PMID: 37448372 DOI: 10.2174/1871526523666230713141153] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 07/15/2023]
Abstract
INTRODUCTION Giardia lamblia is a neglected parasitic infection that typically affects the developing nations of the world. It is a microscopic intestinal parasite that is known to cause stomach cramps, bloating, nausea and bouts of diarrhoea. CASE PRESENTATION Here, we are presenting the case of a 1.5 years-old-baby with an immunocompromised condition who got infected by Giardia lamblia. The baby with fibrosarcoma was receiving treatment in our tertiary care centre, and later developed abdominal and minor systemic complaints. Stool samples were collected, which showed trophozoites and cysts of Giardia. DISCUSSION To the best of our knowledge, this is the first case of Giardia lamblia infection in a paediatric patient with fibrosarcoma. The patient improved after taking metronidazole for ten days. CONCLUSION It is critical to keep a watch out for this neglected parasite, and suggested samples, particularly stool samples, must be sent for investigation in order to diagnose and manage these cases properly.
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Affiliation(s)
- Twishi Shrimali
- Department of Microbiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan 342005, India
| | - Saumya Srivastava
- Department of Microbiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan 342005, India
| | - Naila Mohammad
- Department of Microbiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan 342005, India
| | - Nikhil John
- Department of Microbiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan 342005, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan 342005, India
| | - Rahul Saxena
- Department of Paediatric Surgery, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan 342005, India
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Kundu A, Srivastava S, Tak V, Goyal JP. Cryptosporidiosis in Yellow Nail Syndrome - A Rare Case Report. Infect Disord Drug Targets 2023; 23:73-75. [PMID: 36125824 DOI: 10.2174/1871526522666220920142423] [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: 04/16/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cryptosporidium species infection causes malabsorption and severe diarrhea in immunocompromised hosts. Association of Yellow Nail Syndrome (YNS) and Cryptosporidiosis is rare and has not been reported till date. Immunity can also be affected in this case of YNS is associated with autoimmune disorders. CASE PRESENTATION Here, we describe a case of persistent diarrhea in an 8 month old YNS patient. Modified Ziehl-Neelsen staining and Saffranine-Methylene blue revealed oocyts of Cryptosporidium species. Following appropriate treatment, the patient's symptoms improved and the patient was discharged in a hemodynamically stable condition. DISCUSSION Cryptosporidiosis is a significant cause of morbidity and mortality in immunocompromised patients. YNS per se as well as treatment including steroids leads to immunosuppression in individuals making them susceptible host for opportunistic infections like Cryptosporidiosis. CONCLUSION Clinicians should be aware of the condition and screen for Cryptosporidiosis in any immunocompromised patients with diarrheal symptoms, as parasitic infection like this are opportunistic in them.
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Affiliation(s)
- Aditya Kundu
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Saumya Srivastava
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Jagdish Prasad Goyal
- Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, India
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Mohapatra S, Venugopal SJ, Kalaivani M, Kant S, Tak V, Panigrahy R, Chunchanur SK, Kocher D, Behera B, Pundir S, Chaudhuri S, Gautam H, Sood S, Das BK, Kapil A, Kumar A, Kumari R, Ambica R, Hari P, Malhotra S, Salve HR, Venugopal SJ, Tak V, Panigrahy R, KChunchanur S, Chaudhuri S, Hari P, Das S, Raghav PR, Kant S. Antibiotic resistance of uropathogens among the community-dwelling pregnant and nonpregnant female: a step towards antibiotic stewardship. BMC Infect Dis 2022; 22:939. [PMID: 36513989 DOI: 10.1186/s12879-022-07914-1] [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: 03/28/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Indiscriminate and widespread use of antibiotics has resulted in emergence of many antibiotic-resistant organisms. Antibiotic administration during pregnancy is mostly avoided, unless there is compelling medical condition. We hypothesized that the uropathogens isolated from pregnant women would be more susceptible to antibiotics compared to those isolated from nonpregnant women, thus will be helpful in formulating separate empiric guideline for pregnant women based on the resistance pattern. METHODS This was a prospective cross-sectional study conducted over a period of 2 years in which females with the clinical diagnosis of either cystitis or asymptomatic bacteriuria during pregnancy were included from the community settings. Uropathogen species and their antimicrobial resistance pattern were compared between the pregnant and nonpregnant groups. After accounting for centre-to-centre variation and adjusting for age and socio-economic status, the adjusted odds ratio for antibiotic resistance was calculated and compared between pregnant and nonpregnant women using logistic regression analysis. RESULTS A total of 1758 women (pregnant: 43.3%; nonpregnant: 56.6%) were screened in the study over a period of 2 years, out of which 9.3% (163/1758) were having significant bacteriuria. Escherichia coli and Klebsiella pneumoniae were the two commonest uropathogen in both the groups; their prevalence being 83.6% in pregnant women and 85.2% in nonpregnant women, respectively. Resistance against ampicillin, cefixime, cefoxitin, ceftazidime, ceftriaxone and amoxicillin-clavulanic acid were found significantly lower in the pregnant women compared to nonpregnant. After adjusting the age and socio-economic status accounting for centre-to-centre variation, the odds of resistance for cefixime, amoxicillin-clavulanic acid and co-trimoxazole were found lower and statistically significant among the pregnant women group. CONCLUSIONS The antimicrobial resistance was significantly higher among the community-dwelling nonpregnant women compared to pregnant women in case of few antibiotics. The study highlighted the need of building local antibiogram that could help to initiate the empirical treatment and thus prevent emergence of antimicrobial resistance.
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Affiliation(s)
- Sarita Mohapatra
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Shwetha J Venugopal
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Rajashree Panigrahy
- Department of Microbiology, Institute of Medical Sciences and Sum Hospital, Bhubaneswar, India
| | - Sneha K Chunchanur
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Deepak Kocher
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Birasen Behera
- Department of Microbiology, Institute of Medical Sciences and Sum Hospital, Bhubaneswar, India
| | - Swati Pundir
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Susmita Chaudhuri
- Translational Health Science and Technology Institute, Faridabad, India
| | - Hitender Gautam
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Sood
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Bimal Kumar Das
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Arti Kapil
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Arvind Kumar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - R Ambica
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Pankaj Hari
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Sumit Malhotra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Harsal Ramesh Salve
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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22
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Kaur N, Tak V, Nag VL, Agarwal A, Bhatia PK, Gupta N, Khera D, Goel AD. Comparative evaluation of colistin susceptibility testing by Disk Diffusion and Broth Microdilution methods: An experience from a tertiary care hospital. Infect Disord Drug Targets 2022; 23:IDDT-EPUB-127187. [PMID: 36284393 DOI: 10.2174/1871526523666221025121801] [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: 06/09/2022] [Revised: 09/06/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Recent times have seen uninhibited use of colistin due to emergence of carbapenem resistant gram-negative bacteria especially in India and the most common method still employed by most of the laboratories for in vitro testing of colistin is disk diffusion method. OBJECTIVE The study aimed to compare two methods for colistin susceptibility testing Methods: This retrospective observational study was done on a total of 212 non-duplicate carbapenem resistant gram-negative isolates from patients attending our tertiary care hospital from April 2019 to June 2020. Colistin susceptibility testing for these isolates was done by disk diffusion method followed by broth microdilution method. RESULTS We found out that disk diffusion method showed relatively low sensitivity [34.5%; 95%CI: 19.94-52.65] but high specificity [99.45%; 95% CI: 96.97 - 99.90] in detecting colistin resistant organisms in comparison to broth microdilution method. CONCLUSION Disk diffusion method is an unreliable method at detecting colistin resistance. Therefore, we should always rely on susceptibility testing by standard broth microdilution or newly introduced broth disk elution method before dispatching the report even in resource limited settings. The early and accurate reporting of susceptibility results can preserve the therapeutic value of the drug until we have newer treatment options available in the country.
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Affiliation(s)
- Navneet Kaur
- Department of Microbiology, All India Institute of Medical Sciences, Rajkot, Gujarat, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Ashwini Agarwal
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pradeep Kumar Bhatia
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Neeraj Gupta
- Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Daisy Khera
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Akhil Dhanesh Goel
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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23
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Shrimali T, Sharma A, Ghosh A, Morya A, Tak V, Nag V. P444 Detection of causative agents of infectious keratitis in patients from western rajasthan. Med Mycol 2022. [PMCID: PMC9515898 DOI: 10.1093/mmy/myac072.p444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objective To determine the spectrum of causative agents, the related risk factors, and their association in patients of infectious keratitis. Methodology It was a prospective study conducted over a period of 18 months from August 2018 to January 2020, which included 100 patients attending the Ophthalmology OPD with features of keratitis. Ophthalmological examination was followed by corneal scrapings’ collection, which were subjected to culture, microscopy, and molecular diagnostic tools. Bacterial isolates were identified by conventional methods and MicroScan Walkaway system while the isolated fungi were identified conventionally. Pan-fungal primers were used to detect fungal elements directly from the sample. Results Out of 100, 41 cases were positive by culture, of which 32 (78.04%) had fungal and nine (21.95%) had bacterial keratitis. Fusarium spp. accounted for 33.33% of fungal and Pseudomonas aeruginosa accounted for 55.55% of the bacterial isolates. Fungal material was detected in 41% using pan fungal primers. Cases were maximally recorded during July-October. Traumatic history was present in 78% patients caused by vegetative matter (49%). A male preponderance (67%) was also observed. Four patients underwent evisceration in spite-of rigorous management. Conclusion Poor prognosis emphasizes the need for faster diagnostics, which can detect the causative agents from the clinical specimen itself, reinforcing the concept of clinical metagenomics.
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Affiliation(s)
- Twishi Shrimali
- All India Institute of Medical Sciences Jodhpur , Jodhpur , India
| | - Anuradha Sharma
- All India Institute of Medical Sciences Jodhpur , Jodhpur , India
| | - Anup Ghosh
- Post Graduate Institute of Medical Education and Research , Chandigarh , India
| | - Arvind Morya
- All India Institute of Medical Sciences Jodhpur , Jodhpur , India
| | - Vibhor Tak
- All India Institute of Medical Sciences Jodhpur , Jodhpur , India
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24
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Jain V, Nare T, Vishwakarma K, Kundu A, Radhkrishnan A, Tak V, Kumar D, Sharma A, Kothari N. P049 Candidemia: Isolate profiling and antifungal susceptibility testing experience from Jodhpur, Western India. Med Mycol 2022. [PMCID: PMC9509851 DOI: 10.1093/mmy/myac072.p049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objectives The study was undertaken over a 9-month study period at a tertiary care and super specialty hospital situated in Jodhpur, Western Rajasthan, India, with the following objectives: Methods Automated blood culture bottles (BD BACTEC 960) that flagged positive were taken up for gram staining. Those bottles which showed gram-positive budding yeast with or without pseudohyphae were selected as the study isolates for candidemia. All such bottles were subcultures on Sabouraud's dextrose agar and incubates aerobically at 37°C for 2-5 days. Creamy, pasty, off-white colonies of Candida were further taken up for identification by germ tube testing, CHROM agar, and VITEK-MS. Antifungal susceptibility testing was performed for all isolates by VITEK 2 against fluconazole, caspofungin, voriconazole, micafungin, flucytosine, and amphotericin B. Results During the study period May 1, 2021-January 31, 2022, the microbiology laboratory received a total of 10 841 automated blood culture bottles, of which, overall, 1051 flagged positive. Budding yeasts were seen in 92 bottles. The prevalence of candidemia was found to be 1.49%. Budding yeasts made up 8.75% of all positive blood cultures. Conventional and automated identification methods showed the non-albicans Candida made up the majority (85.87%) of isolates. Candida tropicalis (43.47%) was the most common species overall, followed by C. parapsilosis (17.37%), C. albicans (14.13%), C. guilliermondi (5.43%), C. glabrata (5.43%), and C. auris (4.34%). Two isolates each of C. kruzei, C. utilis, C. rugosa, and Trichosporon spp. were also obtained. The antifungal susceptibility testing results for the commonest species C. tropicalis showed susceptibility of 90% against caspofungin and micafungin, 82% against fluconazole and voriconazole, 45% for flucytosine, and 47.5% against amphotericin B. C. albicans showed 100% susceptibility to fluconazole, and caspofungin, while C. parapsilosis showed a lower susceptibility percentage against all drugs in the panel. The two strains of C. auris were solely susceptible to caspofungin. Demography of the patients showed a male preponderance (M:F ratio was 2:1). The mean age of patients was 44 years. Conclusion The prevalence of candidemia in Jodhpur, Western India was found to be 1.45%, a figure much less than that reported from most other tertiary care centers of the country. The commonest isolate was C. tropicalis (43.47%), same as that reported from most Indian studies. Our isolates were largely (>90%) susceptible to the drug of choice caspofungin, including the multidrug-resistant C. auris strains. The study findings reflect a low prevalence of candidemia, indicating adequate antibiotic and antifungal stewardship practices at Jodhpur.
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Affiliation(s)
- Vidhi Jain
- All India Institute of Medical Sciences , Jodhpur, Jodhpur , India
| | - Tejashree Nare
- All India Institute of Medical Sciences , Jodhpur, Jodhpur , India
| | | | - Aditya Kundu
- All India Institute of Medical Sciences , Jodhpur, Jodhpur , India
| | | | - Vibhor Tak
- All India Institute of Medical Sciences , Jodhpur, Jodhpur , India
| | - Deepak Kumar
- All India Institute of Medical Sciences , Jodhpur, Jodhpur , India
| | - Ankur Sharma
- All India Institute of Medical Sciences , Jodhpur, Jodhpur , India
| | - Nikhil Kothari
- All India Institute of Medical Sciences , Jodhpur, Jodhpur , India
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Mathur P, Malpiedi P, Walia K, Srikantiah P, Gupta S, Lohiya A, Chakrabarti A, Ray P, Biswal M, Taneja N, Rupali P, Balaji V, Rodrigues C, Lakshmi Nag V, Tak V, Venkatesh V, Mukhopadhyay C, Deotale V, Padmaja K, Wattal C, Bhattacharya S, Karuna T, Behera B, Singh S, Nath R, Ray R, Baveja S, Fomda BA, Sulochana Devi K, Das P, Khandelwal N, Verma P, Bhattacharyya P, Gaind R, Kapoor L, Gupta N, Sharma A, VanderEnde D, Siromany V, Laserson K, Guleria R, Malhotra R, Katoch O, Katyal S, Khurana S, Kumar S, Agrawal R, Dev Soni K, Sagar S, Wig N, Garg P, Kapil A, Lodha R, Sahu M, Misra M, Lamba M, Jain S, Paul H, Sarojini Michael J, Kumar Bhatia P, Singh K, Gupta N, Khera D, Himanshu D, Verma S, Gupta P, Kumar M, Pervez Khan M, Gupta S, Kalwaje Eshwara V, Varma M, Attal R, Sudhaharan S, Goel N, Saigal S, Khadanga S, Gupta A, Thirunarayan M, Sethuraman N, Roy U, Jyoti Raj H, D'Souza D, Chandy M, Mukherjee S, Kumar Roy M, Goel G, Tripathy S, Misra S, Dey A, Misra T, Ranjan Das R, Bashir G, Nazir S, Ranjana Devi K, Chaoba Singh L, Bhargava A, Gaikwad U, Vaghela G, Sukharamwala T, Ch. Phukan A, Lyngdoh C, Saksena R, Sharma R, Velayudhan A. Health-care-associated bloodstream and urinary tract infections in a network of hospitals in India: a multicentre, hospital-based, prospective surveillance study. Lancet Glob Health 2022; 10:e1317-e1325. [PMID: 35961355 DOI: 10.1016/s2214-109x(22)00274-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 04/28/2022] [Accepted: 06/07/2022] [Indexed: 01/04/2023]
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Ahlawat K, Jangra R, Chaturvedi S, Prakash C, Dixit A, Fulwani D, Gupta A, Jain N, Tak V, Prakash R. Photocatalytic oxidation conveyor "PCOC" system for large scale surface disinfection. Rev Sci Instrum 2022; 93:074101. [PMID: 35922331 DOI: 10.1063/5.0082222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
In this paper, we present a surface decontamination system that substitutes traditional chemicals and scrubbing agents, which will be useful for the general public during a pandemic. The technique is based on a hybrid process in which UV-C light and its photons interact with metal oxide nano-catalysts to generate hydroxyl radicals, which can enhance the deactivation process, and the system can work even in the shadow regions via a dry process. The optimum number of UV light sources in combination with TiO2 nanoparticles catalysts on aluminum plates have been used synergistically in the system. The UV dose in the disinfection chamber has been optimized, which is between 60 and 500 mJ/cm2 throughout the disinfection chamber. The concentration of hydroxyl radicals is reported more than 25 000 ions/cm3 within the disinfection chamber. These ions are circulated throughout the disinfection volume. The disinfection efficiency has been tested on bacteria and spores, and the obtained results are correlated. Around 8 log reductions in the counts of the test bacteria of Escherichia coli and Klebsiella pneumoniae have been achieved in just 2 min of exposure in the continuous operation of the system. Tests have also been performed on Geobacillus stearothermophilus spores, and the method described here is the result of multiple tests, a review of the scientific literature, and the incorporation of current laboratory practice. The deactivation tested in the system is larger than that of known bacteria and viruses in terms of UV-doses, signifying its utility during the pandemic.
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Affiliation(s)
- Kiran Ahlawat
- Indian Institute of Technology Jodhpur, Karwar, Jodhpur 342037, Rajasthan, India
| | - Ramavtar Jangra
- Indian Institute of Technology Jodhpur, Karwar, Jodhpur 342037, Rajasthan, India
| | - Shivam Chaturvedi
- Indian Institute of Technology Jodhpur, Karwar, Jodhpur 342037, Rajasthan, India
| | - Chandra Prakash
- Indian Institute of Technology Jodhpur, Karwar, Jodhpur 342037, Rajasthan, India
| | - Ambesh Dixit
- Indian Institute of Technology Jodhpur, Karwar, Jodhpur 342037, Rajasthan, India
| | - Deepak Fulwani
- Indian Institute of Technology Jodhpur, Karwar, Jodhpur 342037, Rajasthan, India
| | - Ankur Gupta
- Indian Institute of Technology Jodhpur, Karwar, Jodhpur 342037, Rajasthan, India
| | - Neha Jain
- Indian Institute of Technology Jodhpur, Karwar, Jodhpur 342037, Rajasthan, India
| | - Vibhor Tak
- Indian Institute of Technology Jodhpur, Karwar, Jodhpur 342037, Rajasthan, India
| | - Ram Prakash
- Indian Institute of Technology Jodhpur, Karwar, Jodhpur 342037, Rajasthan, India
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Bansal Y, Maurya V, Tak V, Bohra GK, Kumar D, Goel AD, Yadav T, Nag VL. Clinical and laboratory profile of patients with amoebic liver abscess. Trop Parasitol 2022; 12:113-118. [PMID: 36643982 PMCID: PMC9832495 DOI: 10.4103/tp.tp_38_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/09/2020] [Revised: 07/13/2020] [Accepted: 09/10/2020] [Indexed: 11/25/2022] Open
Abstract
Context Amebic liver abscess (ALA) occurs in 3%-9% of the amebiasis cases, with complications seen in 20%-40% of the cases and 2%-18% mortality rate. Successful treatment thus requires the accurate identification of these cases. Aims and Objectives We aimed to assess the seropositivity and profile of ALA patients in western Rajasthan. Materials and Methods This retrospective study was conducted at a tertiary care center in western Rajasthan from November 2017 to May 2019. Serological diagnosis of ALA was done by detecting immunoglobulin G (IgG) antibodies in the serum of the patients by ELISA. The derangements in laboratory profile (hematological and biochemical parameters) and ultrasonography findings were assessed from the hospital records. Statistical analysis was performed using Mann-Whitney U-test. Results Among the total cases (n = 34), 20 were diagnosed as ALA. Twenty-one (61.8%) were positive for anti-amebic IgG antibodies. Among ALA patients, 14 (70%) were >40 years old and only 6 (30%) patients were of age ≤40 years. Male: female ratio was 5.7:1, and ultrasonography records of 15 ALA patients revealed the presence of hepatomegaly (n = 7, 46.7%), pleural effusion (n = 3, 20%), lung collapse (n = 2, 13.3%), and vascular involvement (n = 1, 6.7%). The right lobe of the liver was involved in majority of the patients (n = 12, 80%). Total white blood cell count (P < 0.001), absolute neutrophil count (P = 0.001), total serum bilirubin (P = 0.019), and serum alkaline phosphatase (P = 0.018) were significantly elevated in ALA patients. Conclusions Seroprevalence shows that ALA still remains the dominant etiology in liver abscess patients in this region. There are significant derangements in the laboratory profile that require a larger study for corroboration.
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Affiliation(s)
- Yashik Bansal
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vinod Maurya
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Gopal Krishna Bohra
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Deepak Kumar
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Akhil Dhanesh Goel
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Taruna Yadav
- Department of Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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28
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Yadav M, Pundir S, Kumari R, Kumar A, Venugopal SJ, Panigrahy R, Tak V, Chunchanur SK, Gautam H, Kapil A, Das B, Sood S, Salve HR, Malhotra S, Kant S, Hari P, Chaudhuri S, Mohapatra S. Virulence gene mutations as a differentiator of clinical phenotypes: insights from community-acquired uropathogenic Escherichia coli. Microbiology (Reading) 2022; 168. [PMID: 35380532 DOI: 10.1099/mic.0.001161] [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] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Uropathogenic Escherichia coli (UPEC) remains an important cause of urinary tract infection during pregnancy. Multiple molecular virulence determinants and antibiotic resistant genes facilitate its pathogenesis and virulence phenotype. Hence it is hypothesized that there will be considerable variation in genes among the isolates from symptomatic as well as asymptomatic bacteriuria (ABU) during pregnancy. The aim of this study was to decipher the genetic variation among the two phenotypes. Six different UPEC isolates collected from urine specimens of consecutive pregnant females (five, symptomatic bacteriuria and one, ABU) were tested for their growth kinetics, and biofilm formation. A total of 87 virulence determinants and 56 antibiotic resistance genes were investigated using whole-genome sequencing, to identify putative drives of virulence phenotype. In this analysis, we identified eight different types of fully functional toxin antitoxin (TA) systems [HipAB, YefM-YoeB, YeeU-YeeV (CbtA), YhaV-PrlF, ChpBS, HigAB, YgiUT and HicAB] in the isolates from symptomatic bacteriuria; whereas partially functional TA system with mutations were observed in the asymptomatic one. Isolates of both the groups showed equivalent growth characteristics and biofilm-formation ability. Genes for an iron transport system (Efe UOB system, Fhu system except FhuA) were observed functional among all symptomatic and asymptomatic isolates, however functional mutations were observed in the latter group. Gene YidE was observed predominantly associated with the biofilm formation along with few other genes (BssR, BssS, YjgK, etc.). This study outlines putative critical relevance of specific variations in the genes for the TA system, biofilm formation, cell adhesion and colonization among UPEC isolates from symptomatic and asymptomatic bacteriuria among pregnant women. Further functional genomic study in the same cohort is warranted to establish the pathogenic role of these genes.
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Affiliation(s)
- Manisha Yadav
- Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Swati Pundir
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Science, New Delhi, India
| | - Arvind Kumar
- Department of Medicine, All India Institute of Medical Science, New Delhi, India
| | - Shwetha J Venugopal
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Rajashree Panigrahy
- Department of Microbiology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Science, Jodhpur, India
| | - Sneha K Chunchanur
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Hitender Gautam
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Arti Kapil
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Bimal Das
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Sood
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Harshal Ramesh Salve
- Centre for Community Medicine, All India Institute of Medical Science, New Delhi, India
| | - Sumit Malhotra
- Centre for Community Medicine, All India Institute of Medical Science, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Science, New Delhi, India
| | - Pankaj Hari
- Department of Pediatrics, All India Institute of Medical Science, New Delhi, India
| | - Susmita Chaudhuri
- Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Sarita Mohapatra
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
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Katoch O, Katyal S, Srivastav S, Rodrigues C, Rupali P, Chakrabarti A, Ray P, Tak V, Biswal M, Nath R, Mukhopadhyay C, Bhattacharya S, Padmaja K, Deotale V, Venkatesh V, Wattal C, Ma T, Nag VL, Ray R, Behera B, Baveja S, Karuna T, Singh SK, Fomda B, Devi SK, Das P, Khandelwal N, Verma P, Gaind R, Bhattacharyya P, Kumar P, Srivastava A, Iravane J, Majumdar T, Sharma R, Sankara D, Kalwaje Eshwara V, Varma M, Nazir S, Tripathy S, Mishra S, Dey A, Thangavelu P, Kapoor L, Malhotra R, Walia K, Guleria R, Mathur P. Self-reported survey on infection prevention and control structures in healthcare facilities part of a national level healthcare associated infection surveillance network in India, 2019. Am J Infect Control 2022; 50:390-395. [PMID: 34600081 DOI: 10.1016/j.ajic.2021.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Healthcare associated infections (HAIs) are prevalent and difficult to treat worldwide. Most HAIs can be prevented by effective implementation of Infection Prevention and Control (IPC) measures. A survey was conducted to assess the existing IPC practices across a network of Indian Hospitals using the World Health Organization designed self-assessment IPC Assessment Framework (IPCAF) tool. METHODS This was a cross sectional observation study. Thirty-two tertiary care public and private facilities, part of the existing Indian HAI surveillance network was included. Data collected was analyzed by a central team at All India Institute of Medical Sciences, New Delhi, a tertiary care hospital of India. The WHO questionnaire tool was used to understand the capacity and efforts to implement IPC practices across the network. RESULTS The overall median score of IPCAF across the network was 620. Based on the final IPCAF score of the facilities; 13% hospitals had basic IPC practices, 28% hospitals had intermediate and 59% hospitals had advanced IPC practices. The component multimodal strategies had the broadest range of score while the component IPC guidelines had the narrowest one. CONCLUSIONS Quality improvement training for IPC nurses and healthcare professionals are needed to be provided to health facilities.
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Affiliation(s)
- Omika Katoch
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Sonal Katyal
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Sharad Srivastav
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Camilla Rodrigues
- Department of Microbiology, P. D. Hinduja Hospital and Medical Research Center, Mumbai, Maharashtra, India
| | - Priscilla Rupali
- Department of Infectious Diseases, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Arunaloke Chakrabarti
- Department of Microbiology, Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Pallab Ray
- Department of Microbiology, Assam Medical College, Assam, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Manisha Biswal
- Department of Microbiology, Assam Medical College, Assam, India
| | - Reema Nath
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | | | - Sanjay Bhattacharya
- Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
| | - Kanne Padmaja
- Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Vijayshri Deotale
- Department of Microbiology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | - Vimala Venkatesh
- Department of Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Chand Wattal
- Department of Clinical Microbiology and Immunology, Sir Ganga Ram Hospital, New Delhi, India
| | - Thirunarayan Ma
- Department of Microbiology, Apollo Hospital, Chennai, Tamil Nadu, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Raja Ray
- Department of Microbiology, Institute of Post-Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Bijayini Behera
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sujata Baveja
- Department of Microbiology, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
| | - Tadepalli Karuna
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh
| | - Sanjeev K Singh
- Department of Infection Control, Amrita Institute of Medicine Sciences, Amrita University, Kochi, Kerala, India
| | - Bashir Fomda
- Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | | | - Padma Das
- Department of Microbiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Neeta Khandelwal
- Department of Microbiology, Government Medical College, Surat, Gujarat, India
| | - Prachi Verma
- Department of Critical Care Medicine, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur
| | - Rajni Gaind
- Department of Microbiology, Safdarjung Hospital and VMMC, Delhi, India
| | - Prithwis Bhattacharyya
- Department of Anaesthesiology and ICU, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Puneet Kumar
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashutosh Srivastava
- Department of Microbiology MGM Medical College, Bhopal, Madhya Pradesh, India
| | - Jyoti Iravane
- Department of Microbiology, Govt. Medical College, Aurangabad, Maharashtra, India
| | - Tapan Majumdar
- Department of Microbiology, AGMC & GBP Hospital, Agartala,, Tripura, India
| | - Rajni Sharma
- Department of Microbiology, SMS Medical College, Jaipur, Rajasthan, India
| | - Dhanapaul Sankara
- Department of Microbiology, K.A,V.P. Govt. Medical College, Trichy, Tamil Nadu, India
| | | | - Muralidhar Varma
- Department of Infectious Diseases, Kasturba Medical College, Manipal, Karnataka, India
| | - Shaista Nazir
- Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Swagata Tripathy
- Department of Anesthesia and Critical Care Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Satyajeet Mishra
- Department of Anesthesia, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Anupam Dey
- Department of General Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Premkumar Thangavelu
- Department of Infectious Disease, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Lata Kapoor
- Department of Microbiology, National Institute of Disease Control, New Delhi, India
| | - Rajesh Malhotra
- Department of Orthopedics, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Kamini Walia
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Randeep Guleria
- Department of Pulmonary Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Purva Mathur
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India.
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Srivastava S, Kundu A, Sivakumar H, Tak V, Meena DS, Samantray S, Kumar D. A case of Toxoplasma gondii and Strongyloides stercoralis coinfection in an immunocompromised patient. Infect Disord Drug Targets 2022; 22:109-111. [PMID: 35184717 DOI: 10.2174/1871526522666220218114426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/12/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND In India, around 23.49 lakhs people are living with HIV/AIDS(PLHA). Strongyloidiasisand Toxoplasmosis are some of the opportunistic infectionsin HIV patients, but their dual coinfection with HIV is rarely reported. CASE PRESENTATION A 46-year-old male admitted to the hospital with generalized weakness, loss of weight, and bleeding per rectum for the last 3 months and few episodes of dizziness and fever . RESULTS On routine investigations, he was diagnosed with human immunodeficiency virus (HIV) infection. On Further evaluation, Toxoplasma gondii and Strongyloides stercoralis, as assessed by parasitological diagnosis of the serum sample, was positive. Patient was started on Artesunate, ART regimen (Tab, TLD- Dolutegravir 50 + Lamivudine 300 + Tenofovir DF 300) and Cotrimoxazole. CONCLUSION We report here a case of Toxoplasma gondii and Strongyloides stercoralis coinfection in an immunocompromised patient.
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Affiliation(s)
- Saumya Srivastava
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur,India
| | - Aditya Kundu
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur,India
| | - Haripriya Sivakumar
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur,India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur,India
| | - Durga Shankar Meena
- Department of Medicine, All India Institute of Medical Sciences, Jodhpur,India
| | | | - Deepak Kumar
- Department of Medicine, All India Institute of Medical Sciences, Jodhpur,India
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Kalita JM, Naveenraj P, Jain V, Kumar D, Tak V, Garg PK, Nag VL. Cystic Echinococcosis of Liver and Spleen Communicating to the Lung: A Rare Case. J Lab Physicians 2022; 14:351-354. [PMID: 36119428 PMCID: PMC9473947 DOI: 10.1055/s-0042-1742416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
AbstractThe annual cystic echinococcosis (CE) incidence in endemic countries is between 1 and 200 per 100,000 population. The clinical manifestations of CE are associated with damage or dysfunction of target organs and affect primarily the liver in around 70% of cases and lungs in around 20% of cases. The involvement of the spleen is rarely seen, representing 2 to 6% of all CE cases. We describe a 60-year-old female patient who presented with 15 days' history of intermittent fever and abdominal distension, having significant hepatosplenomegaly. CE was diagnosed involving the liver, spleen, and lungs and was confirmed radiologically and microbiologically. CE is caused by the larval or cystic stage of the zoonotic dog-tapeworm. Humans can be infected by ingestion of contaminated food or water. At present, there are nine species under the genus Echinococcus with E. granulosus sensu stricto having worldwide distribution, while the rest are focally distributed. CE involving multiple organs is rare. CE should be taken into consideration in patients with these symptoms in endemic areas.
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Affiliation(s)
- Jitu Mani Kalita
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - P. Naveenraj
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vidhi Jain
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Deepak Kumar
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pawan Kumar Garg
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Mohapatra S, Panigrahy R, Tak V, J. V. S, K. C. S, Chaudhuri S, Pundir S, Kocher D, Gautam H, Sood S, Das BK, Kapil A, Hari P, Kumar A, Kumari R, Kalaivani M, R. A, Salve HR, Malhotra S, Kant S. Prevalence and resistance pattern of uropathogens from community settings of different regions: an experience from India. Access Microbiol 2022; 4:000321. [PMID: 35355869 PMCID: PMC8941965 DOI: 10.1099/acmi.0.000321] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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] [Received: 09/16/2021] [Accepted: 12/17/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Urinary tract infection (UTI) is one of the most common infections in clinical practice worldwide in both healthcare and community settings causing significant morbidity and mortality. It is one of the major conditions at the community level treated empirically and regarded as a potential cause of emergence of antimicrobial resistance (AMR). Limited information is available regarding community-acquired UTI (CA-UTI) from India. Methodology This is a first of its kind, multicentric-cross-sectional study at the community level targeting patients attending the out-patient department (OPD) of the community health centre (CHC) from four geographical regions (North, South, West and East) of India. The study had been designed to determine the epidemiology, antibiogram profile and identification of extended-spectrum beta-lactamase (ESBL) producer and carbapenem resistant (CR) uropathogens. Samples were collected prospectively from UTI suspected patients coming at CHC and processed at the tertiary healthcare centres using a common standard operating procedure. Clinical history of all the patients exhibiting significant bacteriuria was collected and data was analysed. Result Overall, 250 out of a total of 2459 (10.1 %) urine samples were positive for bacteria with significant bacteriuria (adult: paediatrics, 6.7 : 1). Females were predominantly affected (male: female, 1 : 2.9). History of recent episode of UTI was observed as the commonest risk factor followed by diabetes mellitus. Altogether, 86 % of total cases were caused by Escherichia coli (68 %) and Klebsiella pneumoniae (17.6 %) together. Among the commonly used oral antibiotics for the Gram-negative bacilli (GNB), the highest resistance was observed against beta-lactams, first- and second-generation cephalosporins, fluoroquinolones and co-trimoxazole. Overall, the prevalence of ESBL producer and CR isolates were 44.8, and 4.3 %, respectively. However, the ESBL production, CR and nitrofurantoin resistance among the uropathogenic E. coli (UPEC) isolates was 52.8, 5.1 and 14 %, respectively. No resistance was found against fosfomycin among the UPEC isolates. Conclusion The current study highlights the increasing incidence of AMR among uropathogens at the community-settings of India. A significant percentage of ESBL producers among the isolated UPEC and K. pneumoniae were observed. The currently available evidence supports the clinical recommendation of fosfomycin and nitrofurantoin for empiric therapy in CA-UTI in India.
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Affiliation(s)
- Sarita Mohapatra
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Shwetha J. V.
- Department of Microbiology, Bangalore Medical College and Research Institute, Karnataka, India
| | - Sneha K. C.
- Department of Microbiology, Bangalore Medical College and Research Institute, Karnataka, India
| | - Susmita Chaudhuri
- Translational Health Science and Technology Institute, Faridabad, India
| | - Swati Pundir
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepak Kocher
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Hitender Gautam
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Sood
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Bimal Kumar Das
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Arti Kapil
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Pankaj Hari
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Arvind Kumar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Kumari
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Ambica R.
- Department of Microbiology, Bangalore Medical College and Research Institute, Karnataka, India
| | - Harshal Ramesh Salve
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sumit Malhotra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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Choudhary GR, Jain P, Pandey H, Madduri VKS, Singh M, Gupta P, Goyal S, Tak V, Nag VL. Frequency and Antibiotic Susceptibility of Pathogens from Cases of Urinary Tract Infection: A Prospective Observational Study. J Lab Physicians 2022; 14:265-270. [PMID: 36119433 PMCID: PMC9473945 DOI: 10.1055/s-0042-1742419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objectives
Urinary tract infection (UTI) is one of the most common diagnoses in patients visiting urology clinics. Rampant use of empiric and inadequate doses of antibiotics leads to an increase in resistance and poses a huge financial burden. We evaluated UTI in relation to antibiotics used, frequency, susceptibility, and resistance pattern of different pathogens at a tertiary care center and made some important observations.
Methods
Prospectively 729 patients diagnosed with UTI attending a urology outpatient department from July 2018 to January 2020 were managed accordingly. Antibiotics were started on the basis of urine culture and sensitivity (c/s) or empirically and changed according to subsequent urine c/s. Repeat urine c/s was performed after 5 to 7 days of starting therapy and 10 days after completion of therapy.
Results
Out of 729 subjects, 417 (57.2%) were males and 312 (42.8%) were females. The most common symptom at diagnosis was dysuria 512 (70.2%), whereas 221 (30.3%) patients presented with fever.
Escherichia coli
was the most common organism isolated, 453 (62.1%). Among 729 patients, 239 took antibiotics without c/s report, whereas in 490 patients antibiotics were prescribed after the report. A total of 431 (59.1%) patients required one antibiotic session for clearance of pathogen, whereas 135 (18.5%) required two sessions, and three sessions were required in 66 (9%) cases. Among 239 patients whose culture came out to be positive, 145 (60.6%) were found to be resistant to the previously given antibiotic and the common pathogens isolated were
E. coli
(61 [42%]),
Pseudomonas
(28 [19.3%]),
Enterococcus
(22 [15.1%]),
Klebsiella
(14 [9.6%]), and others.
Conclusion
Unchecked, rampant, and inadequate use of antibiotics leads to complicated UTI with the increasing share of
Pseudomonas, Klebsiella
, or other dangerous microbes, which are difficult to treat as well as pose threat in the future.
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Affiliation(s)
| | - Pritesh Jain
- Department of Urology, All India Institute of Medical Sciences, Jodhpur, India
| | - Himanshu Pandey
- Department of Urology, All India Institute of Medical Sciences, Jodhpur, India
| | | | - Mahendra Singh
- Department of Urology, All India Institute of Medical Sciences, Jodhpur, India
| | - Prateek Gupta
- Department of Urology, All India Institute of Medical Sciences, Jodhpur, India
| | - Suresh Goyal
- Department of Urology, Guru Gobind Medical College, Faridkot, Punjab, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
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Srivastava S, Samaddar A, Tak V, Khan S, Bohra GK, Sharma D, Ghosh A, Nag VL. WITHDRAWN: Pulmonary Nocardiosis Caused by Nocardia otitidiscaviarum in an Immunocompromised Patient and Its Review of Literature. Infect Disord Drug Targets 2022; 22:e180122200336. [PMID: 35040421 DOI: 10.2174/1871526522666220118123318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/15/2021] [Accepted: 10/30/2021] [Indexed: 11/22/2022]
Abstract
Since the authors are not responding to the editor’s requests to fulfill the editorial requirement, therefore, the article has been withdrawn by the publisher. Bentham Science apologizes to the readers of the journal for any inconvenience this may have caused. The Bentham Editorial Policy on Article Withdrawal can be found at https://benthamscience.com/editorial-policies-main.php Bentham Science Disclaimer It is a condition of publication that manuscripts submitted to this journal have not been published and will not be simultaneously submitted or published elsewhere. Furthermore, any data, illustration, structure or table that has been published elsewhere must be reported, and copyright permission for reproduction must be obtained. Plagiarism is strictly forbidden, and by submitting the article for publication the authors agree that the publishers have the legal right to take appropriate action against the authors, if plagiarism or fabricated information is discovered. By submitting a manuscript, the authors agree that the copyright of their article is transferred to the publishers if and when the article is accepted for publication.
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Affiliation(s)
- Saumya Srivastava
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur
| | | | - Vibhor Tak
- All India Institute of Medical Sciences, Jodhpur
| | | | - Gopal Krishna Bohra
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur
| | - Deepak Sharma
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur
| | - Arnab Ghosh
- Department of Microbiology Post Graduate Institute of Medical Research(PGIMER) Chandigarh, India
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Sharma K, Tak V, Nag VL, Bhatia PK. An observational study on Carbapenem-resistant Enterobacteriaceae (CRE) colonization and subsequent risk of infection in adult ICU patients. Indian J Med Microbiol 2021. [DOI: 10.1016/j.ijmmb.2021.08.267] [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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Sureka B, Tak V, Nag VL, Rani R, Garg MK, Misra S. Suraksha Chakra: A new scoring system to protect the healthcare workers from COVID. J Family Med Prim Care 2021; 10:1512-1514. [PMID: 34123883 PMCID: PMC8144755 DOI: 10.4103/jfmpc.jfmpc_1768_20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 11/04/2022] Open
Abstract
Doctors, nurses, house cleaning staff and hospital ward attendants are at increased risk of acquiring coronavirus disease 2019 (COVID-19) if there is a breach in the personal protection equipment. A new simple, easy to implement scoring system has been developed by our Suraksha Chakra team which can be used by the policy makers and hospital administrators. The scoring system is not to discourage anyone but constantly reinforce the healthcare workers for safe practices during patient care.
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Affiliation(s)
- Binit Sureka
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Raj Rani
- Department of Nursing College, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Mahendra Kumar Garg
- Department of General Medicine, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Sanjeev Misra
- Director and CEO, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
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Abhishek KS, Shrimali T, Tak V, Nag VL, Banerjee S, Khera S. Primary pelvic echinococcosis though uncommon but not rare. Trop Parasitol 2021; 11:56-59. [PMID: 34195064 PMCID: PMC8213113 DOI: 10.4103/tp.tp_64_19] [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] [Received: 10/01/2019] [Revised: 01/27/2020] [Accepted: 02/01/2020] [Indexed: 11/07/2022] Open
Abstract
Echinococcosis is caused by larva of Echinococcus granulosus. Liver being most commonly involved, other organs/body parts such as bone involvement is not so uncommon, especially in cattle-raising countries such as India. Primary osseous echinococcosis remains undiagnosed until complications have developed. We report a case of complicated pelvic echinococcosis presented with left gluteal mass, acetabulum and femoral head destruction, and reduced hip mobility. Pre- and postoperative chemotherapy with albendazole and en bloc surgical removal of the cyst were advocated as the preferred option of treatment. Primary osseous echinococcosis must be kept in mind when encountering a case of chronic bony mass not responding to antitubercular therapy, and hydatid serology should be performed along with other imaging and histopathological examinations to support or confirm the diagnosis to prevent long-term complications.
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Affiliation(s)
- Kumar S Abhishek
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Twishi Shrimali
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Sumit Banerjee
- Department of Orthopedic, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Sudeep Khera
- Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Sureka B, Nag VL, Garg MK, Tak V, Banerjee M, Bishnoi A, Misra S. Rational use of PPE and preventing PPE related skin damage. J Family Med Prim Care 2021; 10:1547-1553. [PMID: 34123890 PMCID: PMC8144757 DOI: 10.4103/jfmpc.jfmpc_1772_20] [Citation(s) in RCA: 2] [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] [Received: 08/30/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 11/11/2022] Open
Abstract
On 31st December, 2019, an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared in Wuhan, China. On 24 March 2020, there was a nationwide lockdown for 21 days, followed by Janata curfew on 22nd March. As the pandemic has developed and spread across continents, everyone including policy makers have realized shortage of personal protective equipment (PPE) such as N95 respirators, coverall, and face shields. This is one of the major factors putting healthcare workers not only at risk of infection but also to various side effects of prolonged use of PPE. Based on international experiences, new ideas in procuring and mass manufacturing, rational use of PPE equipment is the need of hour, especially for developing nations which lack adequate resources and infrastructure for manufacturing PPEs.
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Affiliation(s)
- Binit Sureka
- COVID-19 Committee Members: Departments of Diagnostic & Interventional Radiology, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Vijaya Lakshmi Nag
- COVID-19 Committee Members: Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Mahendra Kumar Garg
- COVID-19 Committee Members: Department of General Medicine, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Vibhor Tak
- COVID-19 Committee Members: Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Mithu Banerjee
- COVID-19 Committee Members: Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Ashok Bishnoi
- COVID-19 Committee Members: Department of College of Nursing, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Sanjeev Misra
- COVID-19 Committee Members: Director and CEO, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
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Sureka B, Tiwari S, Garg PK, Yadav T, Khera PS, Tak V, Misra S. COVID-19 pandemic: Cleaning and disinfection - What should the radiologist know? Indian J Radiol Imaging 2021; 31:S207-S211. [PMID: 33814786 PMCID: PMC7996686 DOI: 10.4103/ijri.ijri_334_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/28/2020] [Accepted: 07/17/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Binit Sureka
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Sarbesh Tiwari
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Pawan Kumar Garg
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Taruna Yadav
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Pushpinder Singh Khera
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Sanjeev Misra
- Director and CEO, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
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Bansal Y, Maurya V, Aggarwal N, Tak V, Nag VL, Purohit A, Goel AD, Bohra GK, Singh K. Thrombocytopenia in malaria patients from an arid region of Western Rajasthan (India). Trop Parasitol 2021; 10:95-101. [PMID: 33747875 PMCID: PMC7951070 DOI: 10.4103/tp.tp_68_19] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/27/2020] [Accepted: 06/04/2020] [Indexed: 11/04/2022] Open
Abstract
Context The arid climate of Western Rajasthan is challenging for malaria transmission, with the number of cases correlating directly with the annual rainfall pattern. Moreover, >90% of the cases in this region are caused by Plasmodium vivax, which has recently been shown to cause a similar degree of thrombocytopenia as Plasmodium falciparum. Aims and Objectives The aim of the study was to determine the degree of thrombocytopenia in malaria patients and its association with different species of malaria in this region with an unstable malaria epidemiology. Materials and Methods This retrospective study was conducted on all microbiologically confirmed malaria patients with documented platelet counts from August 2017 to October 2018. Microbiological diagnosis was established by rapid diagnostic tests and peripheral blood film examination. Platelet counts were used to assess the degree of thrombocytopenia. Results A total of 130 cases were included in the study, of which 118 (91%) were caused by P. vivax, while the rest 12 (9%) were caused by P. falciparum. Thrombocytopenia was present in 108 (83%) cases, and the mean values of platelets in thrombocytopenic patients with P. vivax and P. falciparum infection were 72600/μL and 48500/μL, respectively. Although P. falciparum infection was significantly associated with severe thrombocytopenia (odds ratio: 4.7, [95% confidence interval 1.3-16.1]), extremely low platelet counts (n = 5) warranting platelet transfusions (n = 1) were seen only in P. vivax cases. Only one patient required platelet transfusions in these patients suggesting good tolerance to thrombocytopenia. Conclusions Avoiding unnecessary transfusions in febrile thrombocytopenic patients with an established malaria diagnosis can help in reducing transfusion-transmitted infections.
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Affiliation(s)
- Yashik Bansal
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vinod Maurya
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Nidhima Aggarwal
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Abhishek Purohit
- Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Akhil Dhanesh Goel
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Gopal Krishna Bohra
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Kuldeep Singh
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Kalita JM, Yedale K, Tak V, Nag VL, Kumar D, Bohra GK. Immune thrombocytopenia, Strongyloides stercoralis hyperinfection syndrome with coinfection of Cryptosporidium: A rare case. INDIAN J PATHOL MICR 2021; 64:221-223. [PMID: 33433454 DOI: 10.4103/ijpm.ijpm_787_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jitu M Kalita
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Kavita Yedale
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vijaya L Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Deepak Kumar
- Department of Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Gopal K Bohra
- Department of Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Abhishek KS, Kombade SP, Gupta N, Tak V, Nag VL, Singh K, Agarwal N. Case Series and Mini-Review on Elizabethkingia meningoseptica, A high Alert Organism Causing Meningitis in Premature Neonates from A Tertiary Care Hospital of Western Rajasthan. Infect Disord Drug Targets 2021; 21:e160921189884. [PMID: 33397245 DOI: 10.2174/1871526520666210104151430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/01/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Elizabethkingia meningoseptica is a ubiquitous organism rarely associated with human diseases, but its association especially among hospitalized premature neonates and immunocompromised individuals are not so common. CASE We report two cases of neonatal bacteraemia and meningitis among low birth weight premature neonates admitted in neonatal intensive care units (NICU) by E. meningoseptica, a high alert organism associated with such conditions. CONCLUSIONS E. meningoseptica, a high alert organism associated with meningitis among premature underweight neonates. High degree of resistant to most of the broad-spectrum antibiotics makes its management a challenging task. A good communication between the clinician and the microbiologist becomes very important for the proper management of the patients.
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Affiliation(s)
| | - Sarika P Kombade
- Department of Microbiology, AIIMS, Basni phase 2, Jodhpur, Rajasthan,India
| | - Neeraj Gupta
- Department of Neonatology, AIIMS, Jodhpur, Rajasthan,India
| | - Vibhor Tak
- Department of Microbiology, AIIMS, Jodhpur, Rajasthan,India
| | | | - Kuldeep Singh
- Department of Pediatrics, AIIMS, Jodhpur, Rajasthan,India
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Ambwani S, Nag V, Kombade S, Tak V, Priyadarshi K. Changing pattern of antimicrobial resistance in clinical isolates from pyogenic infections in tertiary care hospital at Western Rajasthan, India. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.234] [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] Open
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Bansal Y, Tak V, Nag VL. <em>Streptococcus dysgalactiae</em> subspecies <em>dysgalactiae</em> as a cause of urinary tract infection in a diabetic woman: A case report and review of literature. Microbiol Med 2020. [DOI: 10.4081/mm.2020.9176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Group C Streptococci comprises of Streptococcus dysgalatiae that is further divided into two subspecies, namely S. dysgalactiae subspecies equisimilis and S. dysgalactiae subspecies dysgalactiae. S. dysgalactiae subspecies dysgalactiae is mainly an animal pathogen but few cases of human infections have been described in the literature. A 40 year old patient presented to the hospital with complaints of pain in pelvis and suprapubic area. Urine sample of the patient was subjected to microscopy and culture for isolation and identification of the etiological agent. S. dysgalactiae subspecies dysgalactiae was identified from the clinical specimen of the patient by conventional and automated methods. The patient was successfully treated with third generation cephalosporin. With newer or rarely reported pathogens causing human diseases and increase in number of immunocompromised individuals in the population, the pathogenic potential of such isolates should not be undermined and a careful correlation with the clinical profile should help guide a clinician in optimum treatment of the patient.
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Elhence A, Sureka B, Garg MK, Bhardwaj P, Kanchan T, Sinha A, Bhatia PK, Nag VL, Kothari N, Dutt N, Bhaskar S, Tak V, Bishnoi NR, Misra S. Preparing for a COVID-19 pandemic: Redefining roles of multidisciplinary team in a large tertiary hospital in Rajasthan. J Family Med Prim Care 2020; 9:5439-5444. [PMID: 33532376 PMCID: PMC7842448 DOI: 10.4103/jfmpc.jfmpc_1091_20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/09/2020] [Accepted: 09/28/2020] [Indexed: 11/12/2022] Open
Abstract
Through this manuscript, we would like to share our experience with building a COVID hospital, allocating duties, planning and managing supplies during COVID-19 pandemic. This manuscript is prepared by the Doctors of various specialties with vast experience involved in actual planning of the infrastructure and resources. This comprehensive manuscript will help teams to prepare and train, stockpile necessary equipment and prepare their staff to deal with current crisis if there is a surge in infected cases.
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Affiliation(s)
- Abhay Elhence
- COVID-19 Committee Member: Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Binit Sureka
- COVID-19 Committee Member: Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Mahendra Kumar Garg
- COVID-19 Committee Member: Department of Pulmonary and Internal Medicine, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Pankaj Bhardwaj
- COVID-19 Committee Member: Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Tanuj Kanchan
- COVID-19 Committee Member: Department of Forensic Medicine, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Arvind Sinha
- COVID-19 Committee Member: Department of Pediatric Surgery, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Pradeep Kumar Bhatia
- COVID-19 Committee Member: Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Vijaya Lakshmi Nag
- COVID-19 Committee Member: Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Nikhil Kothari
- COVID-19 Committee Member: Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Naveen Dutt
- COVID-19 Committee Member: Department of Pulmonary Medicine, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Suryanarayanan Bhaskar
- COVID-19 Committee Member: Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Vibhor Tak
- COVID-19 Committee Member: Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - N R Bishnoi
- COVID-19 Committee Member: Department of Deputy Director Administration, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
| | - Sanjeev Misra
- COVID-19 Committee Member: Department of Director and CEO, Professor Surgical Oncology, All India Institute of Medical Sciences (AIIMS), Basni, Jodhpur, Rajasthan, India
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Samaddar A, Srivastava S, Khan S, Tak V, Sharma A, Nag VL, Bohra GK. Mycobacterium chelonae bacteraemia in a patient with myasthenia gravis receiving long-term steroid therapy. Access Microbiol 2020; 1:e000069. [PMID: 32974503 PMCID: PMC7491934 DOI: 10.1099/acmi.0.000069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 06/21/2019] [Accepted: 10/01/2019] [Indexed: 11/18/2022] Open
Abstract
Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms found in soil and water. Infections caused by NTM are increasing with conditions ranging from harmless colonization to invasive infections, the latter being more common in immunocompromised hosts. In this report, we present a case of bacteraemia caused by Mycobacterium chelonae, a rapidly growing NTM belonging to Class IV in the Runyon classification, in a 71-year-old male with ocular myasthenia gravis undergoing treatment with oral prednisolone. Gram staining of these organisms from blood culture can be easily overlooked or confused with diptheroids. Detection of Gram-positive bacilli should prompt Ziehl–Neelsen staining to distinguish diphtheroids from rapidly growing mycobacteria in immunosuppressed patients. In addition, speciation and antimicrobial susceptibility testing are of paramount importance in such cases as there is considerable variation in the resistance patterns between different species of NTM. Line probe assay provides a rapid and reliable method for identification of NTM to the species level, which can guide treatment with appropriate antibiotics. This case report highlights the importance of early detection of such cases so as to optimize management and improve patient outcomes.
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Affiliation(s)
- Arghadip Samaddar
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Saumya Srivastava
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Salman Khan
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Anuradha Sharma
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Gopal Krishna Bohra
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Sureka B, Sinha A, Tak V, Garg MK, Bhatia PK, Bhardwaj P, Nag VL, Dutt N, Elhence A, Bhaskar S, Bishnoi A, Chauhan N, Bishnoi NR, Misra S. Customized personal protective equipment (PPE): Solution to conservation and management of supplies during the coronavirus disease 2019 (COVID-19) pandemic. J Family Med Prim Care 2020; 9:2180-2182. [PMID: 32754469 PMCID: PMC7380824 DOI: 10.4103/jfmpc.jfmpc_556_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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] [Received: 04/17/2020] [Revised: 04/25/2020] [Accepted: 04/28/2020] [Indexed: 11/12/2022] Open
Abstract
In the COVID-19 pandemic, global health care systems have become overwhelmed with potentially infectious patients seeking testing and care. Preventing spread of infection to and from health care workers (HCWs) and patients relies on effective use of personal protective equipment(PPE). The most critical part in due course of managing this pandemic is adequate supply of PPEs. We have customized a PPE which is economical and reusable after proper disinfection. This customized PPE can be a solution to conservation of supply during this pandemic.
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Affiliation(s)
- Binit Sureka
- COVID-19 Committee Member: Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Arvind Sinha
- COVID-19 Committee Member: Department of Pediatric Surgery, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Vibhor Tak
- COVID-19 Committee Member: Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Mahendra Kumar Garg
- COVID-19 Committee Member: Department of General Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Pradeep Kumar Bhatia
- COVID-19 Committee Member: Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Pankaj Bhardwaj
- COVID-19 Committee Member: Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Vijaya Lakshmi Nag
- COVID-19 Committee Member: Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Naveen Dutt
- COVID-19 Committee Member: Department of Pulmonary Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Abhay Elhence
- COVID-19 Committee Member: Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Suryanarayanan Bhaskar
- COVID-19 Committee Member: Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Ashok Bishnoi
- COVID-19 Committee Member: Department of College of Nursing, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Nishant Chauhan
- COVID-19 Committee Member: Department of Pulmonary Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - N R Bishnoi
- COVID-19 Committee Member: Deputy Director Administration, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Sanjeev Misra
- COVID-19 Committee Member: Director and CEO, Professor Surgical Oncology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
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Thakur P, Nayyar C, Tak V, Saigal K. Mannitol-fermenting and Tube Coagulase-negative Staphylococcal Isolates: Unraveling the Diagnostic Dilemma. J Lab Physicians 2020; 9:65-66. [PMID: 28042222 PMCID: PMC5015504 DOI: 10.4103/0974-2727.187926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Preeti Thakur
- Department of Microbiology, Chacha Nehru Bal Chikitsalaya, New Delhi, India
| | - Charu Nayyar
- Department of Microbiology, Chacha Nehru Bal Chikitsalaya, New Delhi, India
| | - Vibhor Tak
- Department of Microbiology, Chacha Nehru Bal Chikitsalaya, New Delhi, India
| | - Karnika Saigal
- Department of Microbiology, Chacha Nehru Bal Chikitsalaya, New Delhi, India
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Tak V, Kolita JM, Nag VL, Bohra GK, Kumar D. Chronicle of migrant hyperinfective Strongyloides stercolaris larvae and associated bacteremia in a patient suffering from Idiopathic Thrombocytopenic Purpura. Access Microbiol 2020. [DOI: 10.1099/acmi.fis2019.po0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Vibhor Tak
- All India Institute Of Medical Sciences, Jodhpur, India
| | | | | | | | - Deepak Kumar
- All India Institute Of Medical Sciences, Jodhpur, India
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Samaddar A, Sharma A, Maurya VK, Tak V. Necrotizing fasciitis caused by Apophysomyces variabilis in a burn patient. IDCases 2019; 18:e00660. [PMID: 31799119 PMCID: PMC6883305 DOI: 10.1016/j.idcr.2019.e00660] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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] [Received: 08/18/2019] [Accepted: 10/28/2019] [Indexed: 12/27/2022] Open
Abstract
The genus Apophysomyces belonging to the order Mucorales is increasingly being reported as a cause of mucormycosis in immunocompetent patients. We report a case of necrotizing fasciitis caused by Apophysomyces variabilis in a 52-year-old immunocompetent male who sustained thermal burn in his right leg following a road-traffic accident. There was rapidly progressive necrosis of skin, soft tissues and underlying muscles which required extensive surgical debridement. Microscopic examination of excised tissues revealed broad aseptate fungal hyphae. Fungal culture on Sabouraud dextrose agar (SDA) showed growth of a mucoraceous mould which was identified as A. variabilis based on characteristic microscopic morphology and internal transcribed spacer sequencing of the ribosomal DNA. The isolate was found to sporulate on SDA, a finding that was unique as Apophysomyces spp. does not usually sporulate on primary isolation medium used in mycology laboratories. The disease progressed as there was an initial assumption of bacterial infection and the fungus was isolated late in the course of the disease because of which no antifungal drug was added to the regime. The patient left against medical advice and eventually underwent below-knee amputation at another city hospital a week later. Infection due to A. variabilis should be considered as a differential diagnosis of rapidly progressive necrosis of skin and soft tissues in immunocompetent individuals as early diagnosis and management will prevent the disease progression and a possible amputation.
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Affiliation(s)
- Arghadip Samaddar
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, 342005, Rajasthan, India
| | - Anuradha Sharma
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, 342005, Rajasthan, India
| | - Vinod Kumar Maurya
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, 342005, Rajasthan, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, 342005, Rajasthan, India
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