Acquired immunodeficiency syndrome and related opportunistic infections are a significant cause of morbidity and mortality in susceptible population. This study aims to negate the paucity of data regarding the relation between CD4 levels, prevalence of enteric parasites, and the outcome of treatment with HAART (highly active antiretroviral therapy) and Cotrimoxazole in Kerala, India. Multiple stool samples from 200 patients in a cross-sectional study were subjected to microscopy and Cryptosporidium stool antigen ELISA. Parasites were identified in 18 samples (9%). Cystoisospora and Cryptosporidium spp. were seen in 9 cases (4.5%) and 5 cases (2.5%), respectively. Microsporidium spores and Chilomastix mesnili cysts were identified in 1 case each (0.5% each). Seven cases of Cystoisospora diarrhoea recovered after treatment with Cotrimoxazole. Diarrhoea due to Cryptosporidium spp. in all 5 cases subsided after immune reconstitution with HAART. This study concludes that a positive association was seen between low CD4 count (<200 cells/μL) and overall parasite positivity (P value < 0.01). ELISA is a more sensitive modality for the diagnosis of Cryptosporidium diarrhoea. Chilomastix mesnili, generally considered a nonpathogen, may be a cause of diarrhoeal disease in AIDS. Immune reconstitution and Cotrimoxazole prophylaxis remain to be the best therapeutic approach in AIDS-related diarrhoea.
Monkeypox deaths have been rarely reported across the globe. A total of 19 fatalities have been reported globally from endemic and non-endemic countries in 2022. The current outbreak of Monkeypox had been largely limited to the community of men who have sex with men primarily with multiple bisexual or homosexual partners. The vast majority of the cases infected with Monkeypox had recovered and the complications like sepsis and encephalitis had been reported in the immunocompromised individuals. The mortality in Brazil and Mexico were primarily in the immunocompromised individuals, while in Spain the fatal cases were immunocompetent with no underlying conditions. To date, India had recorded 12 cases of Monkeypox infection from Kerala (n=5) and New Delhi (n=7). Here, we report the rst fatal case of Monkeypox virus (MPXV) infection imported from UAE to Kerala, India in July 2022. A 22-year-old apparently immunocompetent male with no signi cant past medical history was admitted in an unconscious state to a private hospital in Kerala following a single episode of acute onset generalized tonic-clonic seizures. The clinical features, MRI ndings, CSF picture, and EEG ndings of this case suggest encephalitis. Only the case's oropharyngeal/nasopharyngeal swabs (OPS/NPS) were found to be positive for MPXV. The next generation sequencing on OPS/NPS specimen could retrieve 92.76% of the MPXV genome and belonged to A.2 lineage of clade IIb as observed in the other con rmed Monkeypox cases from India.
College, Kottayam, for a period of one year from July 2015. The study design was Analytical Diagnostic Test Evaluation. The study was designed at comparing different phenotypic methods in their sensitivity, specificity, positive predictive value, negative predictive value and accuracy, keeping mec-A gene detection by PCR as the gold standard. The following six phenotypic methods were performed on Staphylococcus aureus isolates-Cefoxitin Disc Diffusion (CDD), Oxacillin Disc Diffusion (ODD), Oxacillin Screen Agar (OSA), Oxacillin E-Strip (ES), Chromogenic agar medium (ChromID® MRSA SMART-biomerieux) and VITEK-2 system (biomerieux). These were then compared with the gold standard method-mecA gene detection by PCR. RESULTSCefoxitin disc diffusion test and VITEK 2 system showed results in agreement with PCR (Sensitivity and specificity 100%). This was followed by Chrome agar (98.36%, 95.79%), Oxacillin screen agar (95.08%, 98.95%), Oxacillin E-test (95.08%, 97.89%) & Oxacillin disc diffusion test (81.96%, 97.89). CONCLUSIONSCefoxitin disc diffusion test which shows total agreement with PCR is a good surrogate marker for detecting methicillin resistance. However, VITEK-2 system and chromogenic agar media are valuable as they are useful in early detection and screening of MRSA.
BACKGROUNDBurkholderia cepacia complex urinary infections are mostly reported in patients who had undergone procedures in hospital set up by contact with contaminated catheters or gel used for lubricating the catheter. Here with present isolation of Burkholderia cepacia complex in patients of uncomplicated UTI who did not have previous history of intervention in the urinary tract. MATERIALS AND METHODSFor reviewing the anti-microbial profile of the urinary pathogen, study was conducted on 1000 consecutive urine samples received in Clinical Microbiology laboratory. Samples were collected from the patients who presented to the outpatient department and from those who were admitted. Samples received included routine antenatal screening urine samples and samples collected from patients undergoing elective surgical procedures. Sterile wide mouthed urine containers used for collection of mid-stream urine. RESULTSOut of 1000 urine samples studied, 192 pure isolates satisfying significant urinary pathogen. Antibiotic susceptibility of all the isolates documented with Whonet 5.6. No pathogen could be separately isolated in 165 samples which yielded mixed growth due to probable contamination with perineal flora by improper collection of the urine sample.Bacterial isolates obtained included Escherichia coli, Klebsiella sp. Enterococci and Pseudomonas isolated commonly in the order. Fungi isolated were predominantly non-albicans Candida species. CONCLUSIONAntimicrobial surveillance plays a definite role in containment of resistant strains of bacteria causing urinary infections. Proper awareness among the health care providers regarding the spread of antibiotic resistance lead to rational prescription practices. Public awareness need to be emphasized through lay media about the unscrupulous self-medication which is contributing to resistance. The public needs to be re-assured about the nature of the condition that waiting for the antibiotic susceptibility study would not cause any excess signs and symptoms and damages.
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