Delftia acidovorans(earlier known as Comamonas acidovorans) is an aerobic,non-fermentative, Cram negative rod,classified in the Pseudomonas rRNA homology Group 111.Reports of isolation of the ...organism from serious infections like central venoug catheter associated bacleremia. corneal ulcers,otitis media exist.The microbiologists can identify this organism based on an orange indole reaction.This reaction demonstrates the organism’s ability to produce anthranilic acid from tryptophan on addition of Kovac’s reagent;which gives the media its characteristic "pumpkin orange" colour.Here we report the isolation of this organism from the Endotracheal tube aspirate of a 4 year old child.With the increasing use of invasive devices,it has become important to recognize these non fermentative gram negative bacilli as emerging source of infection even in immunocompetent individuals.
Background
Over time, COVID-19 testing has significantly declined across the world. However, it is critical to monitor the virus through surveillance. In late 2020, WHO released interim guidance ...advising the use of the existing Global Influenza Surveillance and Response System (GISRS) for the integrated surveillance of influenza and SARS-CoV-2.
Methods
In July 2021, we initiated a pan-India integrated surveillance for influenza and SARS-CoV-2 through the geographically representative network of Virus Research and Diagnostic Laboratories (VRDLs) across 26 hospital and laboratory sites and 70 community sites. A total of 34,260 cases of influenza-like illness (ILI) and Severe acute respiratory infection (SARI) were enrolled from 4 July 2021 to 31 October 2022.
Findings
Influenza A(H3) and B/Victoria dominated during 2021 monsoon season while A(H1N1)pdm09 dominated during 2022 monsoon season. The SARS-CoV-2 “variants of concern” (VoC) Delta and Omicron predominated in 2021 and 2022, respectively. Increased proportion of SARI was seen in extremes of age: 90% cases in < 1 year; 68% in 1 to 5 years and 61% in ≥ 8 years age group. Approximately 40.7% of enrolled cases only partially fulfilled WHO ILI and SARI case definitions. Influenza- and SARS-CoV-2-infected comorbid patients had higher risks of hospitalization, ICU admission, and oxygen requirement.
Interpretation
The results depicted the varying strains and transmission dynamics of influenza and SARS-CoV-2 viruses over time, thus emphasizing the need to continue and expand surveillance across countries for improved decision making. The study also describes important information related to clinical outcomes of ILI and SARI patients and highlights the need to review existing WHO ILI and SARI case definitions.
Introduction: Hepatitis B Virus (HBV) causes acute and chronic liver disease which can progress to cirrhosis and hepatocellular carcinoma. The seroprevalence in India is about 2% to 8%. When compared ...to general population, seroprevalence in HCWs is 2-4 times higher. A 40%-65% of HBV in Health Care Workers (HCWs) is due to occupational exposures. Housekeeping staff are also exposed to risk, as they are involved in handling of inappropriately discarded bio medical waste, low vaccination coverage due to low educational and socio-economic status. This is the first study conducted in India, to do Knowledge Attitude Practice (KAP) assessment using Turning point technology, an innovative method using clickers. Aim: To evaluate the role of educational intervention, to increase hepatitis B vaccination among housekeeping staffs of our hospital. Materials and Methods: This study was conducted for six months, between April-September 2017 in a tertiary care hospital in southern India. The sample size for the given study was 656. Knowledge was assessed in two phases, at baseline and one month after education intervention. Results: The results at baseline showed that average correct response to knowledge on HBV disease, transmission, prevention and post exposure prophylaxis was 22%, 45%, 36% and 26% respectively which improved to 76%, 82%, 90% and 70% respectively post intervention. Attitude and practice towards preventing HBV was analysed at baseline and 60% opined that they were not vaccinated against HBV because of lack of awareness. Conclusion: In the present study percentage of HCWs protected from HBV increased from 26% to 39%. We consider that all cadre of HCWs have right to be protected against hepatitis B in view of their increased risk from occupational exposure. Having institutional protocol, availability of vaccine and test for anti HBs titre will largely influence the vaccination compliance.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
•Dengue virus serotypes were tested in 4963 samples collected across India in 2018.•DENV-2 was the most prevalent serotype in many states of India.•Two genotypes of DENV-1 (I and V) were ...circulating.•Two lineages of DENV-2 genotype IV were circulating.•DENV-3 genotype III and DENV-4 genotype-I were circulating.
A retrospective study was undertaken to investigate the circulating dengue virus (DENV) serotypes and genotypes in India in 2018.
In total, 4963 samples referred to virus research diagnostic laboratories (n=21), the Indian Council of Medical Research-National Institute of Virology (ICMR-NIV) and ICMR-NIV field units (n=2) for diagnosis of dengue in 2018 were tested using a real-time reverse transcription polymerase chain reaction assay for the presence of DENV serotypes. Representative samples were sequenced for the envelope (E) gene.
Regional diversity was observed with regard to the dominant circulating serotypes. DENV-2 was found to be the most common serotype in many states. Thrombocytopenia, petechiae and malaise were associated with DENV-2 infection. Phylogenetic analyses of DENV E gene sequences revealed the circulation of genotypes I and V of DENV-1, two lineages of DENV-2 genotype IV, DENV-3 genotype III and DENV-4 genotype I.
This study found regional differences in the prevalence of circulating DENV serotypes in India, and provides baseline data for continuous molecular surveillance. Molecular surveillance may have implications for predicting large-scale outbreaks of dengue if regional shifts in the predominantly circulating serotypes and genotypes are detected during the early phase of the dengue season.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Introduction: Developing country, like India intestinal parasitic infections are still remaining as the most important health problem in public of concern. The infection remains the most leading ...cause of morbidity and mortality especially among the childrens. It is presumed that the prevalence is high in developing countries probably due to poor sanitary conditions and improper personal hygiene practice. Aim: The main aim of this study was carried to find out the prevalence of intestinal parasitic infection among rural and urban population of Puducherry, India. Materials and Methods: This is a cross-sectional descriptive study carried out between the period September 2016 to December 2018. Random sampling was adopted to collect stool samples from urban and rural population in Puducherry. A door to door survey was done. Stool samples were collected from rural setting (n = 500) and urban setting (n = 506) and transport to the parasitology section, Dept. of Microbiology, JIPMER were subjected to routine stool investigations. The results were recorded, and data were presented in the form of frequency and distribution. Data entry was done in MS Excel and analysis was carried out in SPSS software version 22. Results: Among the rural and urban population, 500 stool samples from the rural population showed nearly 40.4% intestinal parasites Giardia intestinalis (21.2%), Blastocystis spp (8.8%), Entamoeba spp (6.6%), hookworm (2.8%), Ascaris lumbricoides (1%), Hymenolepis nana (0%) and 506 stool samples from urban population showed 20.3% of intestinal parasites (Giardia intestinalis (10.4%), Blastocystis spp (3.7%), Entamoeba spp (3.3%), hookworm (1.7%), Hymenolepis nana (0.9%), Ascaris lumbricoides (0%). There was a noticeable male predominance pattern (31.4%) compared to female showing 29.1% positivity. The increase in the prevalence of intestinal parasites among rural population than the urban population was statistically significant. Conclusion: The stool samples collected from rural population showed high prevalence of intestinal parasite infestation when compared to urban population, hence necessary interventions like health education, awareness creation and medical intervention should be undertaken particularly among the rural population. In our study population, age group between 1-10 years are predominantly infected with these parasites.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Background: Acute lymphoblastic leukemia (ALL) patients are susceptible to hepatitis B infection due to profound immunosuppression and repeated transfusions. However, the comparative effectiveness of ...hepatitis B vaccination in different phases of chemotherapy has not been studied. Aim: In this comparative interventional study (CTRI/2017/08/009402), vaccination in the induction phase (IP) was compared to that in the maintenance phase (MP). Materials and Methods: The participating ALL patients in both groups (29 per group) were vaccinated with double the dose of hepatitis B vaccine at 0, 1, and 2 months. The proportion of patients with seroprotective anti-hepatitis B surface titers (>10 IU/ml) was compared between the two groups after each dose. Results: The seroprotection rates between both the phases were similar following the first (relative risk RR = 4, confidence interval CI: 0.47-33.65) and third (RR = 1.4, CI: 0.73-2.84) doses of vaccination, whereas following the second dose of vaccination, the seroprotection rate in IP was significantly higher than that of MP (RR = 1.9, CI: 1.07-3.35). Conclusion: This study concluded that a 0, 1, and 2 schedule of hepatitis B vaccination has similar efficacy in both the IP and the MP of chemotherapy in ALL patients. As the IP has a higher trend of seroprotection rates compared to MP, vaccination in IP followed by revaccination postchemotherapy may be preferred in countries with a high prevalence of hepatitis B infection.
To report our experience with two tests, anti-cardiolipin antibody test venereal disease reasearch laboratory (VDRL) test and specific treponemal test (Treponema pallidum hemagglutination assay), ...used for screening antenatal, high risk cases and cases from sexually transmitted infection in a tertiary care hospital from January 2006 till December 2008.
A total of 14 639 samples received from various patient groups including antenatal cases, patients attending sexually transmitted disease (STD) clinic, blood donors and HIV positive patients were screened.
Among the 14 639 samples collected, 103 were positive by VDRL test. Of these 89 cases were confirmed by quantitative VDRL test and Treponema pallidum hemagglutination assay. The cumulative seroprevalence over two years was found to be 0.61% in this study. The syphilis seroprevalence reduced from 0.88% in 2006 to 0.40% in 2008. Among the various sub-populations studied, patients attending the sexually transmitted infection clinic showed a seroprevalence of 2.62%. The seroprevalence decreased significantly from 4.00% in 2006 to 1.39% in 2008.
Our study showed a statistically significant declining rate of syphilis in STD clinics as well as the overall seroprevalence. These findings could be interpreted as indicators of improved programmes for prevention and management of STDs.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Herpes simplex virus (HSV) is known to influence the course of pemphigus vulgaris. Relapse, exacerbation, and treatment resistance in patients with pemphigus vulgaris can be due to HSV infection.
To ...characterize the clinical markers of HSV infection among patients with pemphigus.
This was a hospital-based, descriptive study performed with 60 consecutive patients with pemphigus vulgaris. The clinical and laboratory features of patients with documented HSV infection were then compared with those of patients without infection.
HSV infection was confirmed in 23 (38.33%) patients. On univariate analysis, it was noted that male sex (P = .03); presence of fissures (P = .001), hemorrhagic crusts (P = .003), erosions with angulated margins (P = .024), and linear erosions (P = .001); and raised erythrocyte sedimentation rate (P = .015) were found to be significantly associated with HSV infection. In a multivariate analysis, hemorrhagic crusts (P = .015) and linear erosions (P = .008) were found to be independent predictors of HSV infection.
We did not use polymerase chain reaction to detect HSV infection, which could have yielded more cases of HSV infection.
In the clinical setting of pemphigus vulgaris, the presence of fissures, hemorrhagic crusts, linear erosions, erosions with angulated margins and raised erythrocyte sedimentation rate must alert the clinician to the possibility of HSV superinfection.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
There is huge gap between patients requiring organ transplantation and the available organ donor pool. Various strategies are being pursued to expand the organ donor pool. Infection with hepatitis B ...virus (HBV) in the donor is considered a contraindication for organ donation. However, HBV infection is endemic in some regions, and a significant number of donors may harbor chronic HBV infection. Safe transplantation from donors with chronic HBV infection may allow significant expansion of the donor pool in such areas. We report the first instance in India of successful organ harvesting and kidney transplantation from a deceased donor with chronic HBV infection with no evidence of transmission of infection for 1 year after transplantation, and we briefly review the relevant literature.
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