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Volumen 4, Asunto 4 (2015)

Artículo de investigación

Nonfermenting Gram-Negative Bacilli and Urinary Tract Infection -Sorting the Mystery of Infections Caused

Rachana Solanki, Reetika Dawar, Devander Kumar Aggarwal, Hena Rani, Firdaus Imdadi, Sanjeev Jasuja

Background: Aerobic nonfermenting gram-negative bacilli (NFGNB) are now emerging as important uropathogens. Methods: This study was done to know the significance of NFGNB other than P. aeruginosa and Acinetobacter spp. in Urinary Tract Infections (UTI) along with their antibiotic sensitivity pattern. Total 10,198 urine specimens received in eight months period from October 2013 to May 2014 were subjected to quantitative culture as per the standard procedures in the routine microbiology laboratory and the results were noted. Detailed clinical history and laboratory parameters (Total count, Urine microscopy: Pus cell and RBC) were gathered to know the significance of the organism. Results: Total 40.9% of the NFGNB isolates were clinical significant. Common risk factors associated with these NFGNB are ICU stay, previous hospitalization, catheterization and Diabetes Mellitus. Conclusion: Clinical correlation of NFGNB from urine is required before considering them clinically significant or contaminants.

Artículo de investigación

An Outbreak of Hepatitis E Virus in Raipur, Chhattisgarh, India in 2014: A Conventional and Genetic Analysis

Negi SS, Barde PV, Pathak R, Gaikwad U, Das P, Bhargav A

Study Background: An unprecedented outbreak of enterically transmitted acute hepatitis erupted in Raipur between April-June, 2014 claiming lives of 23 persons including 8 pregnant women. It was investigated by serological, biochemical and molecular methods to reveal its etiological agent, prevalence and genotype responsible for the outbreak. Methods: A total of one hundred six (106) blood samples from equal number of suspected cases of acute hepatitis cases presented in AIIMS Raipur for treatment were investigated for Anti-HEV IgM, Anti-HAV IgM, LFT, RT-PCR and sequencing. Results: Serological analysis incriminated HEV as the chief causative agent of this outbreak with attack rate of 68.8% followed by HAV (9.4%) while dual infection was noted in 2 cases (1.8%). Mortality rate of 2.87 per 10,000 population and incidence rate of 1.7% were recorded. In comparison to children and elderly cases, adults age group were more affected with men had higher attack rate than women and children (p<0.01). 98% cases had moderate to severely deranged LFT level. nRT-PCR and sequencing analysis confirmed the presence of HEV genotype 1a. Conclusion: Contamination of municipal water pipelines by sewage drain had triggered this outbreak caused predominantly by HEV genotype 1a with few HAV cases. This warranted the health and municipal authorities to change the defaulted water pipeline and segregate it from sewage drain resulting in progressive decline of this ill feted outbreak.

Artículo de investigación

Brucellosis: An Economically Important Infection

Yasmin Bano, Sajad Ahmad Lone

Brucellosis is one of the world’s major zoonosis, caused by bacteria of the genus Brucella. The world’s most widespread zoonosis affects cattle, sheep, goats, pigs, and other animals, leading to abortion, infertility, and low milk yields. Humans acquire brucellosis from direct contact with livestock or from drinking unpasteurized milk. Brucella spp. are considered as the most common laboratory-acquired pathogens. Several serological tests have been widely used for diagnosis of Brucella such are Rose Bengal plate test (RBPT), Standard tube agglutination test (STAT), complement fixation test (CFT), enzyme linked immunosorbant assay (ELISA). Besides these, polymerase chain reaction (PCR) based identification and typing, fluorescence polarization assay (FPA) are also important diagnostic tools. The worldwide economic losses due to brucellosis are extensive. Although a number of successful vaccines are being used for immunization of animals still no satisfactory vaccine against human brucellosis is available. This review shows world literature and its impact to the history, epidemiology, virulence, diagnosis along with the control measures adopted in all over the world scenario including Indian.

Artículo de revisión

Microbiological Criteria and Quality of Fruits and Fruit Juices in Ethiopia and International Experience

Hylemariam Mihiretie, Kassu Desta

The consumption of fruits and fruit juices could have both positive and negative effect on the part of consumers. Fruits and fruit juices processed under hygienic condition could play important role in enhancing consumersâ health through inhibition of breast cancer, congestive heart failure (CHF), and urinary tract infection. In absence of good manufacturing practice; however, the nutritional richness of fruits and fruit juices makes the product good medium for microbial growth, vehicle of foodborne pathogens and associated complications. Although scanty on Ethiopian side, some countries of the world have set standards for the maximum permissible level of microbes in fruits, fruit juices and related products. The quality of fruits and juices is strictly maintained in developed countries under some law and regulation but in many developing countries where Ethiopia is not an exception; the manufacturer is not concerned about the microbiological safety and hygiene of fruits and juices because of negligence of law.

Artículo de investigación

Comparative Study of Infectious Risks in Diagnostic Laboratories between Public and Private Hospitals in Benin

Honoré Bankolé, Victorien Dougnon, Gildas Hounmanou, Antoine Sintondji, Anlim Aminou, Muriel de Souza, Michel Boko, Lamine Baba-Moussa

Introduction: Laboratory associated infections are serious occupational hazards for laboratory workers who are exposed through various routes. The present study aimed to compare the bacteriological risks encountered at diagnostic laboratories in public and private hospitals in Southern Benin. Methodology: A scorecard of laboratory practices was developed based on WHO laboratory inspection checklist. The private laboratory was split into two sections B1 and B2 and the public in C1 to C5. A total of 125 swabs from hand, cell phones, work surfaces and door knobs were collected from all laboratories and submitted to bacteriological analyses. Results: Apart from some sections of the public laboratories where poor sanitation was noticed, the overall hygiene level are satisfactory in both hospitals even though the private laboratories were significantly safer (p<0.05) than the public ones (68.55% and 55.81% respectively). Bacteriological investigations showed that mobile phones were the most contaminated items in the private labs while work surfaces harboured more germs in the public laboratories. Although private laboratories were contaminated by over 11 bacteria species against 5 from the public labs, coagulase negative Staphylococcus were the most prevalent isolated organisms from both hospitals. All the isolated bacteria form public and private laboratories were multidrug resistant. Conclusions: Though the hygiene level in the private labs was better than in public labs, the risk of lobaratory associated infections is rampant in both areas with respect to isolated organisms. Serious safety instructions and monitoring must be set to avoid worse situations.

Artículo de revisión

Extended Spectrum Beta- Lactamases: A Minireview of Clinical Relevant Groups

Rebecca Sullivan, David Schaus, Michael John, Johannes A. Delport

Extended spectrum beta-lactamases are enzymes that hydrolyze the beta-lactam ring of Beta-lactam antibiotics rendering the organism resistant. ESBL prevalence is still increasing across the globe and have been implicated in hospital acquired infections and complicated urinary tract infections in Canada. TEM, SHV and CTX-M are becoming more common with CTX-M becoming more of importance as it is associated with complicated urinary tract infections. A variety of detection methods can be used including phenotypical methods, molecular methods and automated methods. Several automated instruments are commercially available to detect phenotypic resistance, recently the Clinical Laboratory Standards Institute has altered their breakpoints negating the necessity to perform confirmatory tests. Unfortunately not all of the commercial panels have the ability to detect lower breakpoints. Due to the importance of ESBL producing organisms in both hospital and community acquired infections, the associated increase in cost treating this infections and expanding spread across the globe, there is a need for further research into these enzymes.

Artículo de investigación

Comparison of Illumigene, Verigene, and Amplivue for Rapid Molecular Detection of Clostridium difficile in Pediatric Stool Specimens

Charles J. Sailey, Jackie Neary, Angie Rounsavall, Gail L. Woods

Background: Pediatric Clostridium difficile infection (CDI) has been steadily rising over the past decade and is associated with increased morbidity and mortality. Rapid and accurate diagnostic testing is important in medical management. Due to the low sensitivity of enzyme immunoassays, and the complexity of culture based methods, many labs are utilizing newer molecular techniques for direct detection of nucleic acid in stool. Methods: 59 prospective stool specimens from 57 pediatric patients (aged 4 months to 19 years) with suspected CDI were tested over a 4 month period. Three FDA-cleared molecular platforms, Meridian Illumigene, Nanosphere Verigene, and Quidel AmpliVue, were compared. All samples had a consistency rating (CR) from 1 - 5 (watery - solid) assigned and were refrigerated prior to testing. Those with a CR=5 were excluded. Six positive specimens were frozen for 3 months then retested, and two of those were serially frozen, thawed, and retested 5 more times over 5 months. Results: All 3 platforms agreed for 55 (93%) specimens. There were 17 positive and 38 negative results. Five positive specimens were called BI/NAP1/027 by Verigene. Of the 4 discrepant results, 3 (2 CR=3, 1 CR=2) were invalid by Illumigene and negative by the other platforms. One sample (CR=4) was Verigene indeterminate, Illumigene positive, and AmpliVue negative. All frozen specimens gave correct results on all platforms. Conclusions: These data suggest that each platform offers a viable solution for rapid diagnosis of CDI in children. Additionally, long term frozen samples can be tested reliably.

Reporte de un caso

Bacteraemia Caused by Kytococcus schroeteri in a Pneumonia Patient

Jihye Ha, Keon-Han Kim, Jung-Ok Kim, Jun-Sung Hong, Seok Hoon Jeong, Kyungwon Lee

The genus Kytococcus are pigmented, non-encapsulated, non-motile, aerobic, catalase-positive, Gram-positive cocci in pairs or tetrads. We report a case of Kytococcus schroeteri isolated from a blood specimen of a patient with pneumonia. The isolate was Gram-variable and difficult to identify using conventional biochemical tests.

Artículo de revisión

Middle East Respiratory Syndrome Coronavirus: Current Status and Future Implications

Dereje Gedle, Mengistu Endris, Belay Tessema, Setegn Eshetie, Temesgen Ewunetu, Fetuma Feyera and Gemechu Kumera

In September 2012, a novel coronavirus was recognized, later renamed Middle East Respiratory Syndrome Coronavirus. This novel coronavirus belong lineage C of the genus Beta coronavirus included virus isolates from bats and camels. Fever, cough and shortness of breath were the common initial symptoms. On the other hand, majority of Patients were rapidly progressed to severe pneumonia and renal failure. Dromedary camels are suspected the primary reservoir for MERS CoV infection; suggesting camels to human transmission via contact with their excretion and consuming their product. However, human to human transmission occurred via the respiratory droplet or close contact. There is no specific drug or vaccine available for illnesses caused by MERS-CoV infection. Currently this novel virus is the major emerging respiratory pathogen threats of the world and capable of lethal human infections. Still new cases have been reported around the world particularly Arabian Peninsula. It has been also emerged outside Middle East countries which have not occurred before in South Korea and China since 20 May, 2015.

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