Introduction: Viral hepatitis is one of the leading causes of death and disability. Nearly 1.5 million people die every year from Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) related liver diseases. Reported consequences of HBV and HCV infection in pregnancy include an increased likelihood of occurrence of preterm delivery and low birth weight and perinatal transmission. Aim: To compare Enzyme-Linked Immunosorbent Assay (ELISA) and closed system Polymerase Chain Reaction (PCR) TrueNat for the detection of HBV and HCV among antenatal women attending a tertiary care medical institute. Materials and Methods: This was a hospital-based crosssectional study conducted at the Department of Microbiology, JNIMS, Imphal, Manipur, India, during the period from December 2020 to January 2022. Serum samples were tested using ELISA as well as on the TrueNat PCR. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 23.0. Results: Out of 60 samples, using ELISA (QUALISA), 24 were found to be positive for HBV surface antigen (HBsAg) and 14 were found to be positive for HCV antibodies (HCV Ab). On further testing using TrueNat chip-based closed system Real Time-PCR (RT-PCR) Test, 12 were found to be positive for HBV Deoxyribonucleic Acid (DNA) and five were found to be positive for HCV Ribonucleic Acid (RNA). Conclusion: TrueNat PCR could eliminate the problem of false positivity in the detection of HBV and HCV. It is useful to make clinical decisions on starting antiviral therapy and also in documenting the efficacy of the antiviral therapy.
Introduction: Hepatitis C virus (HCV) has posed a major public health problem globally. Since majority of HCV infected patients are asymptomatic, diagnosis of HCV infection is mainly based on the detection of anti-HCV antibodies by the Enzyme Linked Immunosorbent Assay (ELISA) or Rapid Diagnostic Tests (RDTs) and HCV Ribonucleic Acid (RNA) by real time Polymerase Chain Reaction (PCR) of serum or plasma samples. Aim: To assess the performance of RDT and 4th generation ELISA against real time reverse transcriptase PCR for the detection of HCV. Materials and Methods: A hospital-based cross-sectional study was carried out in the Virology Section, Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Imphal, Manipur, India, for a period of two years from June 2019 to May 2021. The study included 3,254 plasma samples from suspected cases of HCV monoinfection, and HCV/HIV co-infection. The plasma samples were subjected to anti-HCV antibodies by RDT (SD BIOLINE, South Korea) and 4th generation ELISA (Monolisa™ HCV Ag-Ab ULTRA, BioRad, France), and HCV RNA by real time PCR. Data analysis was done using descriptive statistics, and performance of the assays was evaluated by using Cohen kappa test (κ) and Receiver Operating Characteristic (ROC) curve. Results: PCR is considered as the gold standard test. HCV was detected by RDT in 453 (13.92%), ELISA in 413 (12.69%) and RT-PCR in 367 (11.28%) samples. The present study demonstrated sensitivity of 97.55% and specificity of 96.71% with Positive Predictive Value (PPV) of 79.03% by HCV-RDT. The 4th generation ELISA showed high sensitivity of 99.46% and specificity of 98.34%. Using ROC curve, the area under the curve was 81% for ELISA with diagnostic accuracy of 98.46%. Conclusion: 4th generation ELISA is more sensitive and specific than RDT for the detection of HCV infection. Confirmatory HCV-RNA assay could be performed to clear doubts related to false-positive and false-negative findings of the primary screening assays.
BACKGROUNDThe prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) is increasing worldwide and is a growing public health concern. Serious infections due to Staphylococcus aureus and especially due to Methicillin-resistant Staphylococcus aureus has become a major clinical challenge.The present study was planned to determine the prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) from clinical specimens and to determine their antibiotic susceptibility pattern. MATERIALS AND METHODSThe study was carried out in the Department of Microbiology, JNIMS, Manipur, from the year 2016 to 2017. A total of 770 Staphylococcus aureus strains were isolated from clinical specimens like urine, pus, blood, sputum, etc. All strains were identified by standard microbiological techniques. S. aureus strains were subsequently tested for Methicillin resistance by using Cefoxitin discs. The antibiotic susceptibility pattern of all the MRSA strains identified was determined by Kirby-Bauer disc diffusion method. RESULTSA total number of 770 S. aureus was isolated, of which 560 were MRSA. The prevalence of MRSA was different among various clinical specimens with maximum seen in urinary isolates (88.4%) followed by pus (79.6%). All the 560 MRSA strains were found to be resistant to Penicillin (100%); 76.9% to Gentamicin, 73.5% to Amikacin, 74.1% to Erythromycin, 69.2% to Cotrimoxazole, 77.7% to Ciprofloxacin and 60.9% to Tetracycline. MRSA strains were resistant to ≥ 8.0 drugs, multidrug resistance. Sensitivity to Linezolid and Vancomycin was seen. A few (3/560) Vancomycin intermediate Staphylococcus aureus (VISA) strains were identified by E-test. CONCLUSIONHigh rate of prevalence of MRSA with multidrug resistance of MRSA towards commonly used antibiotics was observed. Linezolid was the only antibiotic found to give uniform sensitivity (100%). A few VISA strains were identified. The findings highlight the importance of in vitro susceptibility testing of every isolate of MRSA in clinical laboratories.
BACKGROUNDMethicillin-resistant Staphylococcus aureus (MRSA) is a major cause of hospital acquired and community-acquired infections. MRSA isolates are important for their resistance to many commonly used antibiotics. Vancomycin, a glycopeptide, was considered to be the best alternative for the treatment of MRSA. However, there are increasing number of reports indicating the emergence of vancomycin-resistant S. aureus (VRSA). The prevalence of MRSA in a similar setup in the state showed a prevalence of MRSA to be 84% in 2008. Therefore, the objective of this study was to find prevalence of the VISA amongst the MRSA isolates in our Hospital. MATERIALS AND METHODSA cross-sectional study was conducted in a tertiary care teaching hospital of Imphal, Manipur, India during the period from December 2015 to May 2016. A total of 126 Staphylococcus aureus isolates from different clinical specimens like wound swabs, pus and urine received from inpatients and outpatients of this referral tertiary care hospital were included in the study. Staphylococci were obtained either as pure culture or as an isolate of a polymicrobial infection. S. aureus was identified conventionally. MRSA were identified using cefoxitin disc (30 μg) by Kirby-Bauer disc diffusion technique according Clinical and Laboratory Standards Institute (CLSI) guidelines 2014. All MRSA isolates were subjected to susceptibility testing by the Kirby-Bauer's disc diffusion method using different antimicrobial agents. All the MRSA isolates irrespective of their susceptibility pattern to Vancomycin by disc diffusion were resorted to E-test (bioMerieux) to determine the minimum inhibitory concentration (MIC). MIC ≤2 µg/mL were identified as sensitive, 4 to 8 mg/L were identified as vancomycin-intermediate and isolates with a vancomycin MIC >16 mg/L were identified as vancomycin-resistant S. aureus according to CLSI, 2014. Quality control was performed using the S. aureus ATCC 25213 strain. Antibiotic susceptibility testing of VISA isolates was done by Kirby-Bauer's Disc diffusion method using the same drugs used for MRSA. RESULTSPrevalence of MRSA was (100/126) 79.36%. MRSA isolates were 100% resistant to Penicillin followed by Ampicillin (90%), Cotrimoxazole (76%). 100% sensitivity was seen with Linezolid followed by Ciprofloxacin (75%), Ofloxacin (79%), Nitrofurantoin (76%), Amikacin (62%), Gentamycin (70%) and Tetracycline (66%). Prevalence of VISA isolates was 3% (3/100) in this study. Amongst the VISA isolates, linezolid was the most sensitive for all the three isolates and nitrofurantoin was sensitive for both the urine isolates and clindamycin was also sensitive for the only pus isolate. CONCLUSIONThis study emphasises the need to study the prevalence and antimicrobial susceptibility pattern of MRSA isolates area-wise in order to guide policy on the appropriate use of antibiotics which would minimise the irrational use of vancomycin and so the emergence of resistance to vancomycin.
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