Sepsis and meningitis are few of the most important causes of morbidity and mortality. Even so, establishing a microbial diagnosis for is still arduous and is often achieved in only half of cases by conventional culture techniques. This study was designed to compare the multiplex PCR method with the traditional culture method in sepsis and meningitis. The other aim was to evaluate the reliability of multiplex PCR method. METHODS: Forty-four patients with symptoms of sepsis and meningitis were included in the study. Both culture and multiplex PCR methods were performed for the isolation of most commonly seen pathogen, from bronchoalveolar lavage (BAL) and cerebrospinal fluid (CSF) samples. RESULTS: The conventional culture method detected at least one bacterial isolation in 19 patients. Whereas, the number for multiplex PCR was 44 (100%). The pathogens most commonly detected by PCR were Pseudomonas, Candida, S. pneumonia and CMV. In terms of detection of multiple pathogens, multiplex PCR was significantly efficient than conventional culture (p<0.05). CONCLUSION: The traditional methods, such as culture are often inadequate in detection of the pathogens in sample from patients of sepsis and meningitis. Multiplex PCR assays proved highly sensitive and rapid. Widespread use of PCR methods will not only provide the immediate and appropriate ''agent specific antibiotic treatment'' of sepsis and meningitis, it will also contribute to a reduction in antibiotic resistance.
Background: Tuberculosis (TB) is the commonest opportunistic infection among Human Immunodeficiency Virus (HIV) positive patients in India and HIV/TB co-infection poses a major public health challenge in developing countries. It is estimated that 60-70% of HIV positive patients will develop tuberculosis in their lifetime. The aim of the present study is to record the clinical, radiological profile of pulmonary and Extrapulmonary Tuberculosis (EPTB) in HIV positive patients.Methods: This was a prospective study conducted in the department of Pulmonary medicine, Kempegowda institute of medical sciences. All newly diagnosed HIV patients during the study period were included and screened for tuberculosis irrespective of whether they had signs and symptoms.Results: Among 44(15.94%) patients among 276 HIV positive patients were diagnosed to have tuberculosis. Males (72.72%) were affected more than females (27.27%). Most common affected age group was 31-40 years with a mean age of 38.08 years. Unprotected heterosexual contact was the most common mode of HIV transmission. Fever, weight loss and cough were the commonest symptoms at presentation. Pulmonary TB was diagnosed in 10(22.7%) patients, EPTB in 30(68.3%) and disseminated TB in 4(9%) patients. All the pulmonary TB patients had CD4 count below 250, EPTB below 150 and disseminated TB patients below 50.6(13.63%) patients had pleural effusion, 5(11.36%) had abdominal TB, 5(11.36%) had tubercular meningitis, 4(9%) had intra thoracic lymphadenopathy and one (2.27%) patient had pericardial effusion. Low CD4 count (<150) had statically significant association with HIV/TB co-infection.Conclusions: The prevalence of HIV-TB co-infection was high. Moreover, HIV positive patients need early diagnosis and treatment of active TB. The study has shown clear correlation between clinical data and the laboratory parameter of immunodeficiency (CD4 count) and the temporal development of TB.
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