INTRODUCTION: Rheumatoid arthritis (RA) is autoimmune disease associated with chronic inammation... more INTRODUCTION: Rheumatoid arthritis (RA) is autoimmune disease associated with chronic inammation of joints causing deformities and functional impairment. Diagnosis primarily depends on clinical manifestations because of lack of suitable diagnostic tests. Rheumatoid factor (RF) is an autoantibody specic for Fc portion of human IgG. RF has low specicity as high false positive results are common in general population. Anti CCP antibody is also useful marker to diagnose rheumatoid arthritis and included in one of the criteria of American College of Rheumatology (ACR) /European League against Rheumatism (EULAR) classication of RA. Thus the present study was planned to compare the diagnostic utility of RF and Anti CCP antibody test in Rheumatoid arthritis patients in a Tertiary Care Hospital. AIM & OBJECTIVE: To compare the diagnostic utility of RF and Anti CCP antibody test in Rheumatoid arthritis patients. Material & METHODS: A total of 200 samples were taken from clinically suspect...
To evaluate the synergistic activity of norfloxacin and metronidazole in vitro. Methods: Aerobic ... more To evaluate the synergistic activity of norfloxacin and metronidazole in vitro. Methods: Aerobic (n=36) and anaerobic (n=30) bacterial isolates were obtained from clinical samples collected from urine, stool, pus and blood of patients suffering from urinary tract infections, gangrene, diabetic foot, dental infections, liver abscess, breast abscess, puerperal sepsis and infected traumatic wounds. Antibiotic susceptibility to norfloxacin and metronidazole was determined by minimal inhibitory concentration (MIC). Results: Among the aerobic isolates studied, 6 showed complete synergistic effect to the combination of norfloxacin and metronidazole while 30 showed partial synergistic or additive effects. Among the anaerobic isolates studied, 19 showed complete synergy while 8 showed partial synergy. Only 2 isolates of Bacteroides fragilis and 1 isolate of Porphyromonas asaccharolytica did not show any synergy. Complete synergy is shown by isolates of Salmonella species and Escherichia coli causing diarrhoea, Proteus species and Escherichia coli causing gram negative septicemia and systemic infections like urinary tract infections, Clostridium welchii and Clostridium sporogenes causing gangrene and diabetic foot, Prevotella melaninogenica, Fusobacterium necrophorum and Porphyromonas asaccharolytica causing dental infections, Fusobacterium nucleatum causing liver abscess, Bacteroides fragilis causing liver abscess and breast abscess, Peptostreptococcus anaerobius causing puerperal sepsis and diabetic foot and Peptostreptococcus asaccharolyticus causing traumatic wounds. Conclusion: The combination of norfloxacin and metronidazole has synergistic action in vitro and may may be useful in the treatment of mixed infections.
International Journal of Contemporary Pediatrics, 2017
Background: As infection is a major cause of morbidity and mortality in neonates, early diagnosis... more Background: As infection is a major cause of morbidity and mortality in neonates, early diagnosis and prompt treatment can prevent its serious consequences. The present study was conducted to determine the prevalence of infections in neonatal intensive care unit (NICU) of a tertiary care hospital and to study their risk factors, causative organisms and antimicrobial susceptibility pattern.Methods: Appropriate samples were collected from all neonates with clinical signs and symptoms of infections. Isolation of microorganisms, their identification and antimicrobial susceptibility was done according to standard microbiological techniques.Results: Among 1210 neonates admitted in the NICU, 393 (32.4%) were clinically suspected infections. The prevalence of Septicemia, Pneumonia, and Meningitis were 6%, 1.5%, 0.7% respectively. The predominant organisms causing neonatal infection were Gram negative bacteria followed by fungi and Gram positive bacteria. Among Gram negative bacteria, the an...
International Journal of TROPICAL DISEASE & Health, 2017
Introduction: Antibiotic associated diarrhea (AAD) is a common side effect of treatment with anti... more Introduction: Antibiotic associated diarrhea (AAD) is a common side effect of treatment with antibiotics. Depending on the antibiotic used, up to 25% of patients experience such unpleasant bowel conditions. The normal flora is replaced by pathogenic organisms like Candida species, Clostridium difficile etc which play an important role in the causation of AAD. Almost all the antibiotics have been associated with diarrhea. C. difficile is known to occur as an outbreak in health care settings in cases of AAD. However reports from India are infrequent. Aims: Our present study was undertaken to assess the role of different pathogen in causation of AAD and to evaluate the role of various antimicrobials in causation of AAD.
International Journal of Infectious Diseases, Apr 1, 2016
Background: Mastitis is a disease causing serious psychological and physical difficulties in wome... more Background: Mastitis is a disease causing serious psychological and physical difficulties in women. We report the aerobic bacteria isolated from infected breasts of 44 women diagnosed with lactational mastitis (LM), 10 with periductal mastitis (PM) and 46 diagnosed with granulomatous mastitis (GM). Methods & Materials: Between November2015-June 2015, pus specimens of 100 women diagnosed with mastitis were Gram stained and aerobic cultures were performed. The isolated bacteria were identified by standart microbiological methods and by Phoenix microbiology analyzer (BD Phoenix TM). From 1 LM patient and 19 GM patient's pus samples which showed bacteria on their Gram-stained smears but had sterile cultures, bacterial DNA was isolated. After extraction, the DNA was purified and PCR amplification procedures were performed. 1446-1515nt amplicons were sequenced using the BigDye Terminator v3.1 kit (Applied Biosystems, USA). DNA sequences were examined and edited using MEGA software. Antimicrobial sensitivities of bacteria isolated from cultures were determined by the disc diffusion method. The results were evaluated according to EUCAST 2015 documents. Results: Aerobic bacteria were isolated from 31(70,4%) LM, 6(60%) PM and 19(41,3%) GM patient's samples, S.aureus was found as the most prevalent bacteria (43,1%, 60% respectively) in LM and PM patients. However C.kroppenstedtii was found as the most prevalent bacteria (15,2%) in GM patient's samples. Furthermore, 2 S.aureus, 3 S.epidermidis, 1 S.capitis, 1 Streptococcus spp. 1 S.mitis, 1 L.lactis, 1 K.pneumoniae, 3 C.kroppenstedtii, 1 C.pseudotuberculosis, 1 C.urealyticum DNA were determined from 19(28%) GM patient samples. A statistically significant relation was found between Gram positive bacteria and GM (p<0.05). The most effective antibiotics were trimethoprim-sulfamethoxazole, gentamicin, ciprofloxacin, vancomycin, linezolid for Gram(+)diplococci, ceftazidime, amoxicillin/clavulanic acid, imipenem and gentamicin for Gram(-)bacilli and penicillin, gentamicin, vancomycin, linezolid for Gram(+)bacilli. Conclusion: As a result, for the first time, the bacteria that until now appeared only in animal mastitis (S.saprophyticus, S.capitis, L.lactis) were determined on human granulomateous mastitis. We believe that, the addition of antibiotics penetrating strongly to the adipose tissue and effective on the most common isolated bacteria would be beneficial for the treatment of patients with mastitis.
Determination of antimycobacterial activity of polyenzyme preparation Immunoseb-S using In vitro methods
Trends in Biosciences, 2012
The polyenzyme formulations developed by Advanced Enzyme Technologies Ltd., Thane, Exclzyme and I... more The polyenzyme formulations developed by Advanced Enzyme Technologies Ltd., Thane, Exclzyme and Immunoseb-S, were tested for their ability to inhibit the growth of the tubercle bacilli. For this, the liquid medium method (REMA) was used. It was found that both the formulations have antitubercular properties and can inhibit the growth of M tuberculosis at a Minimum Inhibitory Concentration of 5 and 10 mg/ml respectively. Although it was not possible to show any potentiation of standard drugs by in vitro methods, a detailed study using MDR strains and sensitive strains showed that the novel formulations are equally effective against both sensitive and MDR strains. Exclzyme and Immunoseb-S may hence be a major breakthrough in the management of MDR tuberculosis.
Utility of latex agglutination test in the diagnosis of acute pyogenic meningitis
Annals of Pathology and Laboratory Medicine, 2016
Introduction: Acute pyogenic meningitis is one of the most common and devastating Central Nervous... more Introduction: Acute pyogenic meningitis is one of the most common and devastating Central Nervous System. Difficulty and delay in diagnosis adds to problem in early management of patients. Rapid tests need to be invented so as to curbing the acute pyogenic meningitis cases. Aims: To identify the bacterial pathogens causing acute pyogenic meningitis and to evaluate the role of microscopy, Latex agglutination vis a vis culture in the diagnosis of pyogenic meningitis Methods: Clinically diagnosed cases of Acute pyogenic meningitis were included in the study. Cerebrospinal fluid (CSF) was the specimen of choice. CSF was processed in the microbiology laboratory for bacteriological aerobic culture, microscopy and Latex Agglutionation test (LAT). All the results analyzed statistically. Results: A total of 321 CSF specimens were screened. Among these 50 were from exclusive acute cases . On analysis gram stain positivity was 52%. Sensitivity of the gram staining was 64.29% and specificity wa...
IP International Journal of Medical Microbiology and Tropical Diseases, 2020
Introduction: Co-infection of Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) is a... more Introduction: Co-infection of Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) is a common event due to similar routes of transmission, with significant clinical implications. Progression to liver disease is more rapid in HIV-HBV coinfected patients. The present study was designed to find the sero-prevalence of HBV in newly diagnosed HIV positive patients. Materials and Methods: 200 newly diagnosed HIV positive cases were enrolled in present study. 3-5 cc blood was collected from these patients and HBsAg ELISA was carried out on serum obtained. HBsAg positive samples were processed further to detect HBeAg and anti-HBeAg by ELISA. Liver Function Tests (LFTs) and CD4 T cell count were noted. Results: Out of 200 HIV positive patients, 4% were co-infected with HBV. Out of the 4% co-infected cases 37.5% were HBeAg positive and 62.5% were anti-HBe positive None of the HIV-HBV co-infected case had a CD4 T-cell count >500 cells/µL whereas 55.2% of HIV mono-infected cases had CD4 T-cell counts > 500 cells/µL. 37.5% HIV-HBV co-infected cases had CD4 T-cell count ≤200 cells/µL whereas only 11.4% HIV mono-infected cases had CD4 T-cell count ≤200 cells/µL.HIV-HBV co-infected cases had more deranged liver enzymes. 50% of HIV-HBV co-infected cases belonged to WHO stage II, whereas majority (91.6%) of HIV mono-infected cases belonged to WHO stage I. Conclusion: This study highlights that, routine screening of HBsAg should done in all HIV infected patients and virological markers of HBV, Liver Function Tests and CD4 T cell count of HIV-HBV co-infected patients should be assessed for appropriate management.
World Journal of Microbiology and Biotechnology, 2018
Dysbiosis of intestinal microflora has been postulated in ulcerative colitis (UC), which is chara... more Dysbiosis of intestinal microflora has been postulated in ulcerative colitis (UC), which is characterized by imbalance of mucosal tissue associated bacterial communities. However, the specific changes in mucosal microflora during different stages of UC are still unknown. The aim of the current study was to investigate the changes in mucosal tissue associated microbiota during acute exacerbations and remission stages of UC. The mucosal microbiota associated with colon biopsy of 12 patients suffering from UC (exacerbated stage) and the follow-up samples from the same patients (remission stage) as well as non-IBD subjects was studied using 16S rRNA gene-based sequencing and quantitative PCR. The total bacterial count in patients suffering from exacerbated phase of UC was observed to be two fold lower compared to that of the non-IBD subjects (p = 0.0049, Wilcox on matched-pairs signed rank tests). Bacterial genera including Stenotrophomonas, Parabacteroides, Elizabethkingia, Pseudomonas, Micrococcus, Ochrobactrum and Achromobacter were significantly higher in abundance during exacerbated phase of UC as compared to remission phase. The alterations in bacterial diversity with an increase in the abnormal microbial communities signify the extent of dysbiosis in mucosal microbiota in patients suffering from UC. Our study helps in identifying the specific genera dominating the microbiota during the disease and thus lays a basis for further investigation of the possible role of these bacteria in pathogenesis of UC.
bioRxiv (Cold Spring Harbor Laboratory), Jun 15, 2022
Tuberculosis (TB) affects 2 billion people worldwide and causes 1.5 million deaths every year. Th... more Tuberculosis (TB) affects 2 billion people worldwide and causes 1.5 million deaths every year. There is great need for new TB vaccines that are more efficacious than the currently licensed BCG vaccine, which provides only limited protection. Our goal was to identify potential targets for new TB vaccines by characterizing the immune responses that distinguish individuals with sterilizing protection against TB (TBresisters), defined by presence of TB-specific immune responses and absence of latent infection, from individuals with latent TB infection (LTBI-participants). Cryopreserved peripheral blood mononuclear cells (PBMC) from 13 TB-resisters and 10 LTBIparticipants were analyzed by high dimensional spectral flow cytometry after overnight M. tuberculosis (Mtb) antigenic stimulation or unstimulated control. Activation of conventional and nonconventional T cells, NK cells, and antigen presenting cells (APC) was compared between the two groups. Compared with LTBI-participants, TB-resisters had significantly higher proportions of conventional and nonconventional T cells expressing granzyme B (GranzB) and PD-1, and of polyfunctional cells in unstimulated and Mtb-stimulated conditions. Conversely LTBI-participants had higher expression of CD25, CD69, CD107a, IL10 and IFNγ. An unbiased cluster analysis revealed higher frequency of recently described CD8+GMM+GranzB+ T cells in unstimulated PBMC from TB-resisters than LTBI-participants. APC activation revealed very few differences between TBresisters and LTBI-participants. An exploratory analysis of responses in 14 BCG-recipients with minimal exposure to TB showed multiple differences with TB-resisters and LTBI-participants in PBMC activation; lower polyfunctionality of T cells and APC in Mtb-stimulated PBMC; and absence of CD8+GMM+GranzB+ T cells. We conclude that combined increased T cell expression of GranzB and checkpoint inhibitors may contribute to immune protection against TB and may be targeted by new vaccines.
Japanese Journal of Infectious Diseases, Nov 30, 2009
Leptospirosis is a re-emerging infection, and often occurs in outbreaks. Early diagnosis is impor... more Leptospirosis is a re-emerging infection, and often occurs in outbreaks. Early diagnosis is important for appropriate control measures and treatment. The sensitivity and specificity of the diagnostic test depends on the antigen, which is used for the detection of antibodies. In the present study, an effort was made to purify and characterize leptospiral antigens, and their performance in the laboratory was assessed. Leptospira biflexa semaranga, Patoc was subjected to processing by the heat extraction method, and the crude antigenic preparation was subjected to high-performance liquid chromatography for purification. The purified antigen fractions were subjected to enzyme-linked immunosorbent assay (ELISA) to determine their reactivity. Only the reactive fractions were tested for specificity by ELISA by allowing the fractions to react with positive sera of patients with nonleptospiral illness. H1, the purified antigen fraction of the heat-extracted preparation, was found to be the most reactive and specific of all fractions tested. The protein was found to have a molecular weight of 50 kDa. The performance of H1 in the laboratory was assessed by formulating an in-house ELISA using the H1 antigen. The results were compared with those of microscopic agglutination testing and commercial ELISA. The specificity and sensitivity of in-house ELISA using the H1 antigen were found to be 93.3 and 85.0%, respectively.
International Journal of Tuberculosis and Lung Disease, Mar 1, 2015
Objectives: To evaluate the concordance and safety of induced sputum (IS) and spontaneous sputum ... more Objectives: To evaluate the concordance and safety of induced sputum (IS) and spontaneous sputum (SS), and estimate concordance and time to detection of M. tuberculosis between Low-ensteineJensen (LJ), thin-layer agar (TLA), and the Mycobacteria Growth Indicator Tube system (MGIT). Methods: This was a cohort study. Prisoners with pulmonary tuberculosis (PTB) were followed for 2 years. At baseline and every follow-up visit, three sputum samples were taken on consecutive days (one IS and two SS) and adverse events occurring before, during, and 30 min after IS were registered. All sputum samples were stained with auramine and cultured in LJ, TLA (to test resistance), and MGIT. Results: Five hundred eighty-six IS and 532 SS were performed on 64 PTB patients. Breathlessness (1.6%), cough (1.2%), hemoptysis (0.3%), and cyanosis (0.2%) were the only complications. Concordance between IS and SS was 0.78 (95% confidence interval 0.69e0.87); 11 positive cultures from IS samples were negative in SS, and 11 positive cultures from SS samples were negative in IS. One hundred seventy-eight cultures were positive by any technique: MGIT 95%, LJ 73%, and TLA 57%. Time to detection of M. tuberculosis in LJ, TLA, and MGIT was 31, 18, and 11 days, respectively. Conclusions: The IS procedure is safe in prisons. The MGIT system is better and faster than LJ and TLA in the diagnosis of M. tuberculosis.
INTRODUCTION: Rheumatoid arthritis (RA) is autoimmune disease associated with chronic inammation... more INTRODUCTION: Rheumatoid arthritis (RA) is autoimmune disease associated with chronic inammation of joints causing deformities and functional impairment. Diagnosis primarily depends on clinical manifestations because of lack of suitable diagnostic tests. Rheumatoid factor (RF) is an autoantibody specic for Fc portion of human IgG. RF has low specicity as high false positive results are common in general population. Anti CCP antibody is also useful marker to diagnose rheumatoid arthritis and included in one of the criteria of American College of Rheumatology (ACR) /European League against Rheumatism (EULAR) classication of RA. Thus the present study was planned to compare the diagnostic utility of RF and Anti CCP antibody test in Rheumatoid arthritis patients in a Tertiary Care Hospital. AIM & OBJECTIVE: To compare the diagnostic utility of RF and Anti CCP antibody test in Rheumatoid arthritis patients. Material & METHODS: A total of 200 samples were taken from clinically suspect...
To evaluate the synergistic activity of norfloxacin and metronidazole in vitro. Methods: Aerobic ... more To evaluate the synergistic activity of norfloxacin and metronidazole in vitro. Methods: Aerobic (n=36) and anaerobic (n=30) bacterial isolates were obtained from clinical samples collected from urine, stool, pus and blood of patients suffering from urinary tract infections, gangrene, diabetic foot, dental infections, liver abscess, breast abscess, puerperal sepsis and infected traumatic wounds. Antibiotic susceptibility to norfloxacin and metronidazole was determined by minimal inhibitory concentration (MIC). Results: Among the aerobic isolates studied, 6 showed complete synergistic effect to the combination of norfloxacin and metronidazole while 30 showed partial synergistic or additive effects. Among the anaerobic isolates studied, 19 showed complete synergy while 8 showed partial synergy. Only 2 isolates of Bacteroides fragilis and 1 isolate of Porphyromonas asaccharolytica did not show any synergy. Complete synergy is shown by isolates of Salmonella species and Escherichia coli causing diarrhoea, Proteus species and Escherichia coli causing gram negative septicemia and systemic infections like urinary tract infections, Clostridium welchii and Clostridium sporogenes causing gangrene and diabetic foot, Prevotella melaninogenica, Fusobacterium necrophorum and Porphyromonas asaccharolytica causing dental infections, Fusobacterium nucleatum causing liver abscess, Bacteroides fragilis causing liver abscess and breast abscess, Peptostreptococcus anaerobius causing puerperal sepsis and diabetic foot and Peptostreptococcus asaccharolyticus causing traumatic wounds. Conclusion: The combination of norfloxacin and metronidazole has synergistic action in vitro and may may be useful in the treatment of mixed infections.
International Journal of Contemporary Pediatrics, 2017
Background: As infection is a major cause of morbidity and mortality in neonates, early diagnosis... more Background: As infection is a major cause of morbidity and mortality in neonates, early diagnosis and prompt treatment can prevent its serious consequences. The present study was conducted to determine the prevalence of infections in neonatal intensive care unit (NICU) of a tertiary care hospital and to study their risk factors, causative organisms and antimicrobial susceptibility pattern.Methods: Appropriate samples were collected from all neonates with clinical signs and symptoms of infections. Isolation of microorganisms, their identification and antimicrobial susceptibility was done according to standard microbiological techniques.Results: Among 1210 neonates admitted in the NICU, 393 (32.4%) were clinically suspected infections. The prevalence of Septicemia, Pneumonia, and Meningitis were 6%, 1.5%, 0.7% respectively. The predominant organisms causing neonatal infection were Gram negative bacteria followed by fungi and Gram positive bacteria. Among Gram negative bacteria, the an...
International Journal of TROPICAL DISEASE & Health, 2017
Introduction: Antibiotic associated diarrhea (AAD) is a common side effect of treatment with anti... more Introduction: Antibiotic associated diarrhea (AAD) is a common side effect of treatment with antibiotics. Depending on the antibiotic used, up to 25% of patients experience such unpleasant bowel conditions. The normal flora is replaced by pathogenic organisms like Candida species, Clostridium difficile etc which play an important role in the causation of AAD. Almost all the antibiotics have been associated with diarrhea. C. difficile is known to occur as an outbreak in health care settings in cases of AAD. However reports from India are infrequent. Aims: Our present study was undertaken to assess the role of different pathogen in causation of AAD and to evaluate the role of various antimicrobials in causation of AAD.
International Journal of Infectious Diseases, Apr 1, 2016
Background: Mastitis is a disease causing serious psychological and physical difficulties in wome... more Background: Mastitis is a disease causing serious psychological and physical difficulties in women. We report the aerobic bacteria isolated from infected breasts of 44 women diagnosed with lactational mastitis (LM), 10 with periductal mastitis (PM) and 46 diagnosed with granulomatous mastitis (GM). Methods & Materials: Between November2015-June 2015, pus specimens of 100 women diagnosed with mastitis were Gram stained and aerobic cultures were performed. The isolated bacteria were identified by standart microbiological methods and by Phoenix microbiology analyzer (BD Phoenix TM). From 1 LM patient and 19 GM patient's pus samples which showed bacteria on their Gram-stained smears but had sterile cultures, bacterial DNA was isolated. After extraction, the DNA was purified and PCR amplification procedures were performed. 1446-1515nt amplicons were sequenced using the BigDye Terminator v3.1 kit (Applied Biosystems, USA). DNA sequences were examined and edited using MEGA software. Antimicrobial sensitivities of bacteria isolated from cultures were determined by the disc diffusion method. The results were evaluated according to EUCAST 2015 documents. Results: Aerobic bacteria were isolated from 31(70,4%) LM, 6(60%) PM and 19(41,3%) GM patient's samples, S.aureus was found as the most prevalent bacteria (43,1%, 60% respectively) in LM and PM patients. However C.kroppenstedtii was found as the most prevalent bacteria (15,2%) in GM patient's samples. Furthermore, 2 S.aureus, 3 S.epidermidis, 1 S.capitis, 1 Streptococcus spp. 1 S.mitis, 1 L.lactis, 1 K.pneumoniae, 3 C.kroppenstedtii, 1 C.pseudotuberculosis, 1 C.urealyticum DNA were determined from 19(28%) GM patient samples. A statistically significant relation was found between Gram positive bacteria and GM (p<0.05). The most effective antibiotics were trimethoprim-sulfamethoxazole, gentamicin, ciprofloxacin, vancomycin, linezolid for Gram(+)diplococci, ceftazidime, amoxicillin/clavulanic acid, imipenem and gentamicin for Gram(-)bacilli and penicillin, gentamicin, vancomycin, linezolid for Gram(+)bacilli. Conclusion: As a result, for the first time, the bacteria that until now appeared only in animal mastitis (S.saprophyticus, S.capitis, L.lactis) were determined on human granulomateous mastitis. We believe that, the addition of antibiotics penetrating strongly to the adipose tissue and effective on the most common isolated bacteria would be beneficial for the treatment of patients with mastitis.
Determination of antimycobacterial activity of polyenzyme preparation Immunoseb-S using In vitro methods
Trends in Biosciences, 2012
The polyenzyme formulations developed by Advanced Enzyme Technologies Ltd., Thane, Exclzyme and I... more The polyenzyme formulations developed by Advanced Enzyme Technologies Ltd., Thane, Exclzyme and Immunoseb-S, were tested for their ability to inhibit the growth of the tubercle bacilli. For this, the liquid medium method (REMA) was used. It was found that both the formulations have antitubercular properties and can inhibit the growth of M tuberculosis at a Minimum Inhibitory Concentration of 5 and 10 mg/ml respectively. Although it was not possible to show any potentiation of standard drugs by in vitro methods, a detailed study using MDR strains and sensitive strains showed that the novel formulations are equally effective against both sensitive and MDR strains. Exclzyme and Immunoseb-S may hence be a major breakthrough in the management of MDR tuberculosis.
Utility of latex agglutination test in the diagnosis of acute pyogenic meningitis
Annals of Pathology and Laboratory Medicine, 2016
Introduction: Acute pyogenic meningitis is one of the most common and devastating Central Nervous... more Introduction: Acute pyogenic meningitis is one of the most common and devastating Central Nervous System. Difficulty and delay in diagnosis adds to problem in early management of patients. Rapid tests need to be invented so as to curbing the acute pyogenic meningitis cases. Aims: To identify the bacterial pathogens causing acute pyogenic meningitis and to evaluate the role of microscopy, Latex agglutination vis a vis culture in the diagnosis of pyogenic meningitis Methods: Clinically diagnosed cases of Acute pyogenic meningitis were included in the study. Cerebrospinal fluid (CSF) was the specimen of choice. CSF was processed in the microbiology laboratory for bacteriological aerobic culture, microscopy and Latex Agglutionation test (LAT). All the results analyzed statistically. Results: A total of 321 CSF specimens were screened. Among these 50 were from exclusive acute cases . On analysis gram stain positivity was 52%. Sensitivity of the gram staining was 64.29% and specificity wa...
IP International Journal of Medical Microbiology and Tropical Diseases, 2020
Introduction: Co-infection of Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) is a... more Introduction: Co-infection of Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) is a common event due to similar routes of transmission, with significant clinical implications. Progression to liver disease is more rapid in HIV-HBV coinfected patients. The present study was designed to find the sero-prevalence of HBV in newly diagnosed HIV positive patients. Materials and Methods: 200 newly diagnosed HIV positive cases were enrolled in present study. 3-5 cc blood was collected from these patients and HBsAg ELISA was carried out on serum obtained. HBsAg positive samples were processed further to detect HBeAg and anti-HBeAg by ELISA. Liver Function Tests (LFTs) and CD4 T cell count were noted. Results: Out of 200 HIV positive patients, 4% were co-infected with HBV. Out of the 4% co-infected cases 37.5% were HBeAg positive and 62.5% were anti-HBe positive None of the HIV-HBV co-infected case had a CD4 T-cell count >500 cells/µL whereas 55.2% of HIV mono-infected cases had CD4 T-cell counts > 500 cells/µL. 37.5% HIV-HBV co-infected cases had CD4 T-cell count ≤200 cells/µL whereas only 11.4% HIV mono-infected cases had CD4 T-cell count ≤200 cells/µL.HIV-HBV co-infected cases had more deranged liver enzymes. 50% of HIV-HBV co-infected cases belonged to WHO stage II, whereas majority (91.6%) of HIV mono-infected cases belonged to WHO stage I. Conclusion: This study highlights that, routine screening of HBsAg should done in all HIV infected patients and virological markers of HBV, Liver Function Tests and CD4 T cell count of HIV-HBV co-infected patients should be assessed for appropriate management.
World Journal of Microbiology and Biotechnology, 2018
Dysbiosis of intestinal microflora has been postulated in ulcerative colitis (UC), which is chara... more Dysbiosis of intestinal microflora has been postulated in ulcerative colitis (UC), which is characterized by imbalance of mucosal tissue associated bacterial communities. However, the specific changes in mucosal microflora during different stages of UC are still unknown. The aim of the current study was to investigate the changes in mucosal tissue associated microbiota during acute exacerbations and remission stages of UC. The mucosal microbiota associated with colon biopsy of 12 patients suffering from UC (exacerbated stage) and the follow-up samples from the same patients (remission stage) as well as non-IBD subjects was studied using 16S rRNA gene-based sequencing and quantitative PCR. The total bacterial count in patients suffering from exacerbated phase of UC was observed to be two fold lower compared to that of the non-IBD subjects (p = 0.0049, Wilcox on matched-pairs signed rank tests). Bacterial genera including Stenotrophomonas, Parabacteroides, Elizabethkingia, Pseudomonas, Micrococcus, Ochrobactrum and Achromobacter were significantly higher in abundance during exacerbated phase of UC as compared to remission phase. The alterations in bacterial diversity with an increase in the abnormal microbial communities signify the extent of dysbiosis in mucosal microbiota in patients suffering from UC. Our study helps in identifying the specific genera dominating the microbiota during the disease and thus lays a basis for further investigation of the possible role of these bacteria in pathogenesis of UC.
bioRxiv (Cold Spring Harbor Laboratory), Jun 15, 2022
Tuberculosis (TB) affects 2 billion people worldwide and causes 1.5 million deaths every year. Th... more Tuberculosis (TB) affects 2 billion people worldwide and causes 1.5 million deaths every year. There is great need for new TB vaccines that are more efficacious than the currently licensed BCG vaccine, which provides only limited protection. Our goal was to identify potential targets for new TB vaccines by characterizing the immune responses that distinguish individuals with sterilizing protection against TB (TBresisters), defined by presence of TB-specific immune responses and absence of latent infection, from individuals with latent TB infection (LTBI-participants). Cryopreserved peripheral blood mononuclear cells (PBMC) from 13 TB-resisters and 10 LTBIparticipants were analyzed by high dimensional spectral flow cytometry after overnight M. tuberculosis (Mtb) antigenic stimulation or unstimulated control. Activation of conventional and nonconventional T cells, NK cells, and antigen presenting cells (APC) was compared between the two groups. Compared with LTBI-participants, TB-resisters had significantly higher proportions of conventional and nonconventional T cells expressing granzyme B (GranzB) and PD-1, and of polyfunctional cells in unstimulated and Mtb-stimulated conditions. Conversely LTBI-participants had higher expression of CD25, CD69, CD107a, IL10 and IFNγ. An unbiased cluster analysis revealed higher frequency of recently described CD8+GMM+GranzB+ T cells in unstimulated PBMC from TB-resisters than LTBI-participants. APC activation revealed very few differences between TBresisters and LTBI-participants. An exploratory analysis of responses in 14 BCG-recipients with minimal exposure to TB showed multiple differences with TB-resisters and LTBI-participants in PBMC activation; lower polyfunctionality of T cells and APC in Mtb-stimulated PBMC; and absence of CD8+GMM+GranzB+ T cells. We conclude that combined increased T cell expression of GranzB and checkpoint inhibitors may contribute to immune protection against TB and may be targeted by new vaccines.
Japanese Journal of Infectious Diseases, Nov 30, 2009
Leptospirosis is a re-emerging infection, and often occurs in outbreaks. Early diagnosis is impor... more Leptospirosis is a re-emerging infection, and often occurs in outbreaks. Early diagnosis is important for appropriate control measures and treatment. The sensitivity and specificity of the diagnostic test depends on the antigen, which is used for the detection of antibodies. In the present study, an effort was made to purify and characterize leptospiral antigens, and their performance in the laboratory was assessed. Leptospira biflexa semaranga, Patoc was subjected to processing by the heat extraction method, and the crude antigenic preparation was subjected to high-performance liquid chromatography for purification. The purified antigen fractions were subjected to enzyme-linked immunosorbent assay (ELISA) to determine their reactivity. Only the reactive fractions were tested for specificity by ELISA by allowing the fractions to react with positive sera of patients with nonleptospiral illness. H1, the purified antigen fraction of the heat-extracted preparation, was found to be the most reactive and specific of all fractions tested. The protein was found to have a molecular weight of 50 kDa. The performance of H1 in the laboratory was assessed by formulating an in-house ELISA using the H1 antigen. The results were compared with those of microscopic agglutination testing and commercial ELISA. The specificity and sensitivity of in-house ELISA using the H1 antigen were found to be 93.3 and 85.0%, respectively.
International Journal of Tuberculosis and Lung Disease, Mar 1, 2015
Objectives: To evaluate the concordance and safety of induced sputum (IS) and spontaneous sputum ... more Objectives: To evaluate the concordance and safety of induced sputum (IS) and spontaneous sputum (SS), and estimate concordance and time to detection of M. tuberculosis between Low-ensteineJensen (LJ), thin-layer agar (TLA), and the Mycobacteria Growth Indicator Tube system (MGIT). Methods: This was a cohort study. Prisoners with pulmonary tuberculosis (PTB) were followed for 2 years. At baseline and every follow-up visit, three sputum samples were taken on consecutive days (one IS and two SS) and adverse events occurring before, during, and 30 min after IS were registered. All sputum samples were stained with auramine and cultured in LJ, TLA (to test resistance), and MGIT. Results: Five hundred eighty-six IS and 532 SS were performed on 64 PTB patients. Breathlessness (1.6%), cough (1.2%), hemoptysis (0.3%), and cyanosis (0.2%) were the only complications. Concordance between IS and SS was 0.78 (95% confidence interval 0.69e0.87); 11 positive cultures from IS samples were negative in SS, and 11 positive cultures from SS samples were negative in IS. One hundred seventy-eight cultures were positive by any technique: MGIT 95%, LJ 73%, and TLA 57%. Time to detection of M. tuberculosis in LJ, TLA, and MGIT was 31, 18, and 11 days, respectively. Conclusions: The IS procedure is safe in prisons. The MGIT system is better and faster than LJ and TLA in the diagnosis of M. tuberculosis.
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Papers by Renu Bharadwaj