Group A streptococcus (GAS) is the commonest bacterial cause of pharyngitis. Children in the age group of 5-15 years are most commonly affected. It can also colonize throats of healthy children in ...this age group. Both cases and carriers can transmit it in the community.
Throat swab samples were collected from 1849 asymptomatic and 371 symptomatic children.
The rate of isolation of GAS was 1.41% among the asymptomatic group and 7.55% among the symptomatic group. Nine different emm types were encountered in the asymptomatic children and 14 among the symptomatic children.
Throat swab cultures must be used in all cases of pharyngitis. Early and appropriate antibiotic therapy will prevent complications. Asymptomatic throat carriage of GAS in children was low in our study. However, they can still act as reservoirs. Emm typing helps in understanding epidemiology and finding new types.
Abstract
Objective: To report the clinical profile of acute kidney injury (AKI) associated with scrub typhus. Methods: Retrospective study of hospitalized patients of acute febrile illness who were ...diagnosed scrub typhus and had AKI. Results: 174 (35%) patients (75.9% female), mean age (41.4 ± 15.9 years) were studied. The laboratory abnormalities were: anemia (63.2%), leukocytosis (44.3%), thrombocytopenia (61.5%), hyponatremia (35.6%), hypernatremia (2.9%), and hypokalemia (12.1%), hyperkalemia (11.5%), hypoalbuminemia (56.9%), hepatic dysfunction (70%) and metabolic acidosis (28.7%). The complications of hypotension (5.7%), septic shock (3.4%), pneumonia (10.9%), acute respiratory distress syndrome (ARDS) (11.5%), meningoencephalitis (6.9%), encephalopathy (5.2%), gastrointestinal bleed (1.3%), myocarditis (3.4%), disseminated intravascular coagulation (2.9%) and multi organ failure (MOF) (10.3%) developed during course of hospitalization in these patients. Twenty-five (14.4%) patients required intensive care support (ICU) support and seven (4%) patients were dialyzed. 146 (83.9%) patients survived. Twenty-eight (16.1%) patients died. There was a significant difference in the age, various hematological & biochemical abnormalities, complications and need for ICU support in the non-survival group as compared the survival group. Conclusion: This study shows that AKI in scrub typhus is common and a severe disease. Age, a shorter hospital stay, severities of leukocytosis, thrombocytopenia, azotemia, hypoalbuminemia, hepatic dysfunction and the complications of ARDS, encephalopathy, MOF and need for ICU support are the factors associated with mortality.
Background: During the last two decades, increased resistance to nalidixic acid and ciprofloxacin has become a cause of global concern. The present study was undertaken to ascertain nalidixic acid ...and ciprofloxacin resistance in Salmonella isolates from our region. To know the true pattern of ciprofloxacin resistance by determining the minimum inhibitory concentration (MIC) through E-test.Methods: All the Salmonella isolates recovered from blood cultures were screened for nalidixic acid resistance using 30µg disc by the Kirby Bauer disc diffusion method. Ciprofloxacin susceptibility was done both by disc diffusion and MIC using CLSI breakpoints.Results: We analysed a total of 80 Salmonella isolates during the last three years. Salmonella enterica serovar Typhi was the predominant serovar in 51 (64.8%) isolates, followed by Salmonella enterica serovar Paratyphi A comprising 28 (36.2%) isolates. Amongst the total isolates 78 (97.5%) were nalidixic acid resistant. Of these 54 (67.5%) showed intermediate susceptibility and 9 (11.2%) were ciprofloxacin resistant by the disc diffusion technique. On the contrary 29 (36.2%) had decreased susceptibility to ciprofloxacin; while a larger number 38 (47.5%) were detected resistant to ciprofloxacin on determination of MIC by the E-test.Conclusions: Screening for nalidixic acid acts as a surrogate marker to detect ciprofloxacin resistance. However, the true pattern of ciprofloxacin resistance can be determined by calculating the MIC by the E-test.
Background: The present study was done to assess the bacteriological quality of drinking water in and around Shimla in the event of an outbreak of hepatitis E in Shimla city, January 2016. Methods: ...Total 1098 water samples from different sources were received from January to July 2016. The bacteriological analysis of water was done by the multiple tube technique. Results were interpreted after 48 hours of incubation of the water sample in MacConkey bile broth medium in accordance with Mc Crady probability table. Results: A total of 1098 water samples were received in the Microbiology laboratory of which 129 (11.74%) were unsatisfactory, 25 (2.27%) satisfactory and rest 925 (84.24%) were excellent. Nearly 9.21% samples from water tanks, 2.3% from public taps were unsatisfactory but water samples from all the water ATM s were excellent. Escherichia coli were the commonest isolate 35.6%, Klebsiella pneumoniae 31.6%, Klebsiella oxytoca 19.3%, Enterobacter sps 8% and Citrobacter sps 2%. In the corresponding period 477 patients had come to the health facilities for clinical symptoms of jaundice. The serum samples from clinically suspected cases were subject to antibody testing for IgM HAV and IgM HEV and it revealed that 109 (23%) were positive for HAV while 253 (53%) were positive for HEV. During the above period 75 (15%) patients had co-infection with both HAV and HEV. Conclusions: Bacteriological assessment of drinking water is essential and should be carried out on regular basis so as to prevent outbreaks of Hepatitis A and E and other water borne diseases.
Schizophillum commune
is an environmental fungus rarely causing human infections of diverse nature. Sinusitis occurs in immunocompromised persons and seldom in healthy subjects. Though easily ...isolated, the lack of awareness of its virulence is a bottleneck in the diagnosis of this infection. We report the first case of
S. commune
sinusitis with nasal polyps in an immunocompetent male from the sub-Himalayan region. The computerized tomography scan findings established the clinical diagnosis, and causative agent was confirmed as
S. commune
. A white, woolly mold with septate, hyaline hyphae and characteristic spicules but unclamped connections suggested a monokaryotic isolate. Patient was treated successfully with fiberoptic endoscopic sinus surgery, and no antifungal therapy was instituted. There was no recurrence at review after 1 year.
Localized cutaneous leishmaniasis (LCL) in India is due mostly to Leishmania tropica. It is mainly endemic in the deserts of Rajasthan. Recently, Himachal Pradesh has been identified as a new endemic ...focus for the disease. In the last few years, the number of new cases has been increasing almost to epidemic proportions. This report presents the preliminary findings of clinico-epidemiologic and investigative results of 161 new localized cases of LCL seen between May 2001 and December 2003. The study populaton was composed of 80 males and 81 females between 10 months and 75 years of age. All were indigenous to the sub-alpine valley along the Satluj River in the mountainous region of the Kinnaur District (altitude = 700-2,900 meters). Most patients were seen from April to September and had 1-8 lesions (duration = 1-6 months) that involved mainly the face. Tissue smears were positive for amastigotes in 37% and histopathology showed non-caseating epitheloid cell granuloma in 77% of the cases. Analysis by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) of the ribosomal gene region of 10 biopsy specimens showed amplicons indistinguishable from L. donovani in eight cases and L. tropica in two cases. Leishmania was cultured on modified Nicole-Novy-McNeal (NNN) medium containing RPMI 1640 medium and heat-inactivated fetal bovine serum from 13 of 38 biopsy samples. Three of these isolated strains were identified as L. donovani while a fourth was L. tropica by PCR-RFLP of the ribosomal internal transcribed spacer region. One strain had a gp63 sequence identical to that of east African strains. Another strain had a unique gp63 sequence that has not been found in L. donovani complex strains. Sand flies trapped in the cattle sheds of a few patients were identified as Phlebotomus longiductus (Parrot 1928). Treatment with intralesional sodium stibogluconate was effective in all patients without any major side effects. One patient developed lupoid leishmaniasis that responded to higher dose of sodium stibogluconate. Though rarely reported as a cause of LCL, L. donovani seems to be the predominant pathogen in this new focus of cutaneous leishmaniasis. Phlebotomus longiductus is a possible vector, albeit based on circumstantial evidence.
PDF
