An evaluation of OSOM BV blue test in the diagnosis of bacterial vaginosis

Objective:To determine the prevalence of bacterial vaginosis(BV) in patients with vaginal discharge and evaluate the efficacy of OSOM BV blue test in diagnosis.Methods:OSOM BV blue test,a rapid diagnostic test based on the principle of detection of bacterial sialidase activity in vaginal fluid specimens was conducted.A total of 405 patients in the reproductive age group(15- 45 years) having vaginal discharge were included in the study along with 10 healthy age-matched controls.Two high vaginal swabs were collected aseptically from each patient.One swab was used to make smear for gram staining,and the other was for OSOM BV blue test.Amine test and vaginal pH test were taken as well.Results:The prevalence of bacterial vaginosis was 60.7%. OSOM BV blue test showed good efficacy,as compared with gram staining in diagnosing BV.The sensitivity and specificity of OSOM BV blue test were 97.6%and 97.5%respectively.Amsel’s criteria diagnosed 180(44.4%) cases of BV and had sensitivity and specificity of 67.1%and 90.6%respectively.Thus the performance of OSOM BV blue was better than the methods based on Amsel’s criteria.Conclusions:OSOM BV blue test is an efficacious bed side test,helpful in rapidly making an accurate diagnosis of BV in setups lacking laboratory facilities or expert microbiologists.

bla_(CTX-M),bla_(TEM),and bla_(SHV) in Enterobacteriaceae from North-Indian tertiary hospital:high occurrence of combination genes

Objective:To delineate the frequency of occurrence of bla_(CTX-M),bla_(TEM),and bla_(SHV) in Enterobacteriaceae from North-Indian tertiary hospital.Methods:A random collection of a subset of 45 Escherichia coli(E.coli) and 28 Klebsiella pneumoniae(K.pneumoniae) that was resistant to a third generation cephalosporin and obtained during 2007-2008 was selected for detailed screening for bla_(CTX-M),bla_(TEM),and bla_(SHV) by monoplex PCRs.The isolates demonstrating the presence of bla_(CTX-M) alleles were characterized for the specific CTX-M-genogroup by using a multiplex PCR.Results:Resistance to cefoperazone,ceftazidime,ceftriaxone,cefotaxime, cefoxitin and piperacillin was 100%each in K.pneumoniae isolates,whereas these resistancerates for E.coli isolates were 93.1%,83.8%,91.9%,93.6%,97.3%and 97.1%,respectively. Concomitant resistance to aminoglycosides,quinolones and aztreonam was also noticed.Presence of any of the bla genes(bla_(CTX-M),bla_(TEM),and bla_(SHV)) was noticed in a total of 28(38.4%) isolates of the 73 isolates studied.Many isolates demonstrated occurrence of these genes in various combinations.bla_(CTX-M),bla_(TEM),and bla_(SHV) were noticed in 28.8%,10.9%and 13.7%isolates, respectively.Multiplex PCR in bla_(CTX-M) harboring isolates demonstrated the presence of CTX-MGenogroup -1 and sequencing for the specific CTX-M-type revealed presence of CTX-M-15 type. RAPD typing showed wide diversity in isolates.Conclusions:This is amongst the premier report describing the simultaneous occurrence of blo_(TEM),bla_(SHV),and bla_(ampC) in Indian Enterobacteriaceae and that wider dissemination of these genes,as demonstrated by diversity of isolates,raises concern and emphasizes a need for extensive search for the presence of these gene pools in Indian subcontinent.

Increasing secondary bacterial infections with Enterobacteriaceae harboring bla_(CTX-M-15) and bla_(CMY-6) in patients with bronchogenic carcinoma:an emerging point of concern

Objective:To look for secondary bacterial infections in bronchogenic carcinoma（BCA） with resistant organisms harboring bla genes considering the paucity of relevant studies.Methods: A total of 137 confirmed cases of BCA and 34 healthy volunteers were studied for the occurrence and prevalence of blaCTX-M and and blaAmpC harboring-enterobacteriaceae.A subset of these patients（n=69） was previously reported for the secondary infection with the Aspergillus species. Bronchoalveolar lavages（BAL） were subjected for bacterial and fungal cultures and the bacterial isolates were screened by multiplex PCRs for the presence of blaCTX-M and blaAmpC.The isolates were also screened for the association of insertion sequence（IS26） by PCR and characterized by RAPD for any clonal relatedness.Results:A total of 143 bacterial isolates were obtained from 137 BAL specimens of BC,patients.The Enterobacteriaceae-isolates were multidrug-resistant showing concomitant resistance to fluoroquinolones and aminoglycosides.Both blaCTX-M and blaAmpC of CIT family were detected in 77.4%and 27.4%isolates,respectively.Sequencing revealed the presence of blaCTX-M-15 and blaCMY-6.Twenty one percent of the isolates were simultaneously harboring blaampC and blaCTX-M-15.IS26 PCR and RAPD typing revealed the presence of diverse bacterial population but no predominant clone was identified.The present study also suggests strong association of aspergillosis with lung cancer and further strengthens the potential use of non-validated serological tests suggested earlier.Conclusions:We emphasize that all patients of bronchogenic carcinoma should also be screened for secondary bacterial infections,along with secondary fungal infections,so as to introduce early and specific antimicrobial therapy and to prevent unwanted deaths.

Correlation of Serum C-Reactive Protein with Disease Severity in Tuberculosis Patients

Purpose: To study the factors influencing sputum smear conversion including Serum C-Reactive Protein (CRP) and its correlation with disease severity in tuberculosis patients. Method: Levels of Serum-CRP concentrations were deter-mined in 60 patients with pulmonary tuberculosis, 30 healthy volunteers and patients in follow-up after completion of antitubercular treatment (DOTS therapy). Results: Serum-CRP levels were found to be significantly higher in smear-positive group as compared with the follow-up patients and smear-negative control group. The values were 43.65 ± 23.68, 9.88 ± 5.23 and 4.04 ± 3.85 mg/L respectively (P Conclusion: Serum-CRP levels are significantly correlated with disease severity in patients with active pulmonary tuberculosis. Thus these findings from the present study would certainly add new criteria for early diagnosis of TB, which may lead to development of new strategies to treat TB.

NDM-1 in the Indian environment:hitherto the problem is not disquieting

blaNDM-1 is a recently described novel plasmid-mediated resis tance determinant that confes resistance to carbapenems. Bacteria harbouring NDM-1 have been reported from the clinical specimens.These are also reported and warned as impending gut colonist,and recently described from the environment of the capital city of India,indicating the potential as a reservoir for future infections.

A Study on the Pulmonary Manifestations of Rheumatoid Arthritis from a North Indian Town

Rheumatoid arthritis (RA) is a chronic systemic disease of unknown etiology characterized by articular involvement, extra-articular involvement, and the presence of serum rheumatoid factor. Pulmonary involvement in RA is a common extra-articular manifestation of rheumatoid arthritis (RA) that confers significant morbidity and mortality. We undertook this study to determine the prevalence and spectrum of pulmonary abnormalities in patients with rheumatoid arthritis (RA) from a North Indian town. 62 patients who met the American College of Rheumatology (formerly the American Rheumatism Association) 1987 classification criteria for RA were subjected to clinical examination of chest, X-Ray-chest (CXR), pulmonary function tests (PFT) and high resonance computed tomography (HRCT). 40.3% patients had some pulmonary symptoms with exertional dyspnoea in 21%, cough with expectoration in 17.7%, fine respiratory rales in 11.3%, patients X-ray chest bilateral lower zone haziness in 16% and prominent pulmonary vasculature in 3.2%. 43% had abnormal PFT-restrictive pattern in 29%, obstructive pattern 8% and mixed pattern in 6.4%. HRCT revealed abnormal findings in 33.8% commonest being ground glass pattern in both lower lobes 19.3%, sub pleural reticulations in 9.6%, pleural thickening in 3.2% and pulmonary vascular prominence in 1.6%. To provide optimal treatment, physicians must always consider the possibility of associated pulmonary manifestations when patients with RA are evaluated.