Background
An appropriate specimen is of paramount importance in Real Time reverse transcription-polymerase chain reaction (rRT-PCR) based diagnosis of novel coronavirus (nCoV) disease (COVID-19). Thus, it’s pertinent to evaluate various diversified clinical specimens’ diagnostic utility in both diagnosis and follow-up of COVID-19.
Methods
A total of 924 initial specimens from 130 COVID-19 symptomatic cases before initiation of treatment and 665 follow up specimens from 15 randomly selected cases comprising of equal number of nasopharyngeal swab (NPS), oropharyngeal swab (OPS), combined NPS and OPS (Combined swab), sputum, plasma, serum and urine were evaluated by rRT-PCR.
Results
Demographic analysis showed males (86) twice more affected by COVID-19 than females (44) (p = 0.00001). Combined swabs showed a positivity rate of 100% followed by NPS (91.5%), OPS (72.3%), sputum (63%), while nCoV was found undetected in urine, plasma and serum specimens. The lowest cycle threshold (Ct) values of targeted genes E, ORF1b and RdRP are 10.56, 10.14 and 12.26 respectively and their lowest average Ct values were found in combined swab which indicates high viral load in combined swab among all other specimen types. Analysis of 665 follow-up multi-varied specimens also showed combined swab as the last specimen among all specimen types to become negative, after an average 6.6 (range 4–10) days post-treatment, having lowest (15.48) and average (29.96) Ct values of ORF1b respectively indicating posterior nasopharyngeal tract as primary nCoV afflicted site with high viral load.
Conclusion
The combined swab may be recommended as a more appropriate specimen for both diagnosis and monitoring of COVID-19 treatment by rRT-PCR for assessing virus clearance to help physicians in taking evidence-based decision before discharging patients. Implementing combined swabs globally will definitely help in management and control of the pandemic, as it is the need of the hour.
Various kinds of fungal agents have been observed in the environment. Fungi can enter the human body by penetration following trauma and are responsible for various types of subcutaneous mycotic lesions. In this case report, we present the case of a 47-year-old female patient who presented with swelling on the lateral aspect of the left lower leg above the lateral malleolus. Aspirate from the site was sent for histopathological examination for detection of the fungus. After microbiological investigation, a rare fungus isolated in this patient was identified as Aquastroma magniostiolata by carrying out sequencing at a reference center.
CONTEXT: Carbapenemases are a group of β-lactamases capable of conferring resistance to carbapenems. Carbapenemase producing gram negative bacilli are becoming increasingly prevalent not only in nosocomial infections but in community acquired isolates also posing a threat to antimicrobial therapy of life threatening infections. AIMS & OBJECTIVES: This study was done to identify carbapenemase producing organisms among multidrug resistant clinical isolates and to detect MBL producers among the carbapenemase producing isolates. MATERIALS & METHODS: Gram negative organisms isolated from clinical samples in November-December 2014 were included. The antibiotic susceptibility of isolates was determined by Kirby Bauer method. Multidrug resistant isolates showing reduced suceptibility or resistance to carbapenems were further tested for carbapenemase production by Modified Hodge test (MHT) and MHT positive isolates were further tested for MBL production by combined disc synergy test (CDST). RESULTS: A total of 32 isolates out of 62 carbapenem resistant MDR isolates were positive for carbapenemase production by MHT. Most common isolated carbapenemase producing organisms are Klebsiella species, Escherichia coli, Pseudomonas species and Acinetobacter species. Out of the 32 MHT positive isolates, 4 were positive for MBL production by CDST. MBL producers were 2 Klebsiella isolates, 1 Pseudomonas and 1 Acinetobacter isolate. CONCLUSION: Evaluation of effective antibiotic options and rigorous infection control measures are needed for controlling spread of carbapenemase producing multidrug resistant organisms, especially in hospital setting.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.