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M K Lalitha

Publications and source records attributed to M K Lalitha.

At least 55 records · Page 3Linked to original sources
PubMed1996

Melioidosis In India: the tip of the iceberg?

Diagnosis of melioidosis by the isolation of Burkholderia pseudomallei from one or more body fluid/tissue specimens of 6 Indian subjects, 5 of whom had not travelled outside India, is reported. The places of residence of these 6 and one patient previously reported, namely Tripura (2), Kerala (2), Orissa (1), Tamil Nadu (1) and Maharashtra (1) are therefore potentially endemic for melioidosis. B.pseudomallei closely resembles common contaminant Pseudomonas sp. and are easily mis-identified in microbiology laboratories. We surmise that melioidosis is underdiagnosed and underreported in India and we alert clinicians, microbiologists and public health professionals to the possibility of melioidosis being far more common than previously recognised.

Adolescent↗
PubMed1996

The spectrum of antimicrobial resistance among methicillin resistant Staphylococcus aureus (MRSA) in a tertiary care centre in India.

Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen globally, including India. Staph. aureus strains isolated from pus or blood of patients during January 1993 to November 1994 were tested for antimicrobial susceptibility using Kirby-Bauer disc diffusion technique. Among 1382 isolates of Staph. aureus, 332 (24%) were MRSA. Among the latter, 97 per cent were resistant to trimethoprim-sulphamethoxazole; 85.5 per cent to gentamicin and 45 per cent to amikacin. While over 90 per cent were resistant to norfloxacin and ciprofloxacin, only 53 per cent were resistant to ofloxacin. Fifty seven per cent were susceptible to rifampicin and 87 per cent to netilmicin. All tested strains were susceptible to vancomycin. Therefore, when antimicrobials other than vancomycin are considered for therapy, their choice requires the results of in vitro susceptibility testing of every isolate of MRSA.

Anti-Bacterial Agents↗
PubMed1995

Changing patterns of group B streptococcal serotypes associated with human infections.

One hundred strains of group B streptococci (GBS) isolated from diverse clinical specimens of patients seen in our hospital were subjected to serotyping by an indigenously prepared coagglutination system. Serotype NT/c was the most predominant (24%), followed by Ia (23%), II/c (12%) and Ib (11%). Type Ia was the most predominant in all specimens except genital samples where NT/c was the most predominant. Comparison of the distribution of serotypes identified during 1975-78 with that of the present study showed a great increase in the prevalence of types NT/c, II/c and Ia and a dramatic decline of types III, Ia/c and Ib. Despite the inclusion of reagents for newer serotypes, IV and V two strains were nontypable indicating the prevalence of hitherto unidentified GBS serotypes in our community.

Humans↗
PubMed1994

Serotypes of Streptococcus pneumoniae causing meningitis in southern India. Use of new direct latex agglutination antigen detection tests in cerebrospinal fluid.

The utility of a new latex agglutination (LA) test to directly determine serotypes of Streptococcus pneumoniae in cerebrospinal fluid (CSF) was assessed in prospective evaluation at a referral hospital in southern India. Samples from 18 ill patients with Gram-positive organisms in CSF were tested. The presence of C polysaccharide or specific serotype antigen (types 1, 3, 4, 5, 6, 12, 14, 18, 19, and 23) of S. pneumoniae was detected by slide LA test. Pneumococcal antigen was detected in 17 (94%) of 18 CSF specimens; in 14 (78%) the serotype was determined directly. Serotypes 1, 5, 6, 19, 23, 7, 10, 34, and 38 were found in these patients. A quellung test of the cultured isolates confirmed the serotypes. Information regarding the serotype distribution of pneumococci in varied geographic locations is important for the design and evaluation of pneumococcal vaccines. The slide LA tests seemed useful in detecting S. pneumoniae antigens and in determining the serotype, and have promise in simplifying the gathering of serotype data.

Adult↗
PubMed1994

Unusual manifestations of salmonellosis--a surgical problem.

From January 1981 to December 1992, of 6250 cases of salmonellosis treated at the Christian Medical College and Hospital, Vellore, India, 100 patients with focal pyogenic infection caused by salmonellae required surgical intervention in addition to medical therapy. Thirty-one had involvement of the hepatobiliary system, and 10 more had other intra-abdominal infections. Involvement of bone and joint as well as soft tissue constituted 15% each. The site of infection in patients with soft tissue abscesses included skin (7), parotid (2), thyroid (2), breast (1) inguinal node (1), branchial sinus (1) and injection site (1). Three patients had arterial infections. Noteworthy among the cases of genital infections was one case of salmonella infection in a pre-existing hydrocele, and one case of epididymo-orchitis with a loculated salmonella infection. Salmonella infection in a pre-existing ovarian cyst was seen in a patient with endometriosis. The salmonella serotypes most frequently encountered were S. typhi (36) and S. typhimurium (36), followed by S. paratyphi A (15). The importance of recognition of these protean manifestations of salmonellosis in an endemic setting is discussed. The microbiological evaluation of properly obtained specimens is mandatory in such unusual pyogenic infections.

Abscess↗
PubMed1994

Salmonellosis complicating aortic aneurysms.

We present our experience with two cases of salmonella infected aortic aneurysms. The treatment of salmonella infected aortic aneurysms has been associated with a high mortality, primarily due to the rapidity with which the post-infective complications of salmonellosis develop. Early diagnosis, adequate anti-microbial therapy and improved vascular surgical methods have resulted in a better prognosis for salmonella infected aortic aneurysms.

Aneurysm, Infected↗
PubMed1994

In vitro evaluation of newer beta-lactam antibiotics against gram negative bacilli isolated from neutropenic patients.

The in-vitro susceptibility pattern to newer beta lactams namely Ticer/Clav, Azlocillin, Piperacillin and Imipenem was determined with 50 clinical strains isolated from neutropenic patients with strains isolated from neutropenic patients with sepsis, with an objective of evolving a strategy for empirical antibiotic therapy for febrile neutropenic patients. The MIC90 value for Imipenem for the Gram negative bacilli tested, other than Pseudomonas was < 0.25 mcg/ml therapy revealing a high degree of susceptibility, while for Ps. aeruginosa and related species MIC50 and MIV90 values were 2.0 and 64.0 micrograms/ml respectively. A comparatively lower degree of susceptibility was found among Gram negative bacilli included in the study to ticar/clavu, azlocillin and piperacillin indicating a moderate degree of resistance to these antibiotics. The data from this study suggests that (i) Ureidopenicillins with an aminoglycoside should be effective therapy for proven Pseudomonas and other Gram negative sepsis in febrile neutropenic patients. (ii) Imipenem would be the antibiotic of choice in Gram negative bacterial sepsis in febrile neutropenic patients where the organism is resistant to cephalosporins and ureidopenicillins.

Anti-Bacterial Agents↗
PubMed1993

Transducer related Enterobacter cloacae sepsis in post-operative cardiothoracic patients.

The use of intra-arterial pressure monitoring devices in patients undergoing major cardiac surgery is on the increase. Here we document an outbreak of Enterobacter cloacae septicaemia among seven post-operative cardiothoracic patients. Detailed investigations revealed the source of this nosocomial problem to be contaminated transducer heads. The need to follow strict aseptic measures in handling intra-arterial devices is emphasized, in order to minimize the morbidity and mortality in otherwise low-risk post-operative patients.

Cardiac Surgical Procedures↗
PubMed1993

An outbreak of Serratia marcescens infection among obstetric patients.

An outbreak of S. marcescens infection occurred among 17 obstetric patients during May-June 1990. Simultaneously 11 newborns were also affected. All the 28 strains were identical in their biochemical characteristics, serotype and phage type as well as antimicrobial susceptibility pattern. The source of infection was traced to a contaminated batch of cream, consisting of 0.5 per cent savlon in carboxy methyl cellulose base, used while doing pelvic examination. The affected patients were treated with appropriate antibiotics and there was no mortality. No further infection was reported after the removal of the contaminated cream.

Adult↗
PubMed1993

Short course ciprofloxacin therapy for enteric fever.

A short course of ciprofloxacin, 750 mgm b.i.d. for 7 days was found to be effective in the treatment of enteric fever in 21 hospitalized patients with S.typhi (18) and S.paratyphi A(3). Median time for fever response was 3 days. All isolates were susceptible to ciprofloxacin (MIC 0.0078-0.062 mcgm/ml). The mean serum peak and trough levels were 5.4 and 1.6 mcgm/ml respectively. Stool cultures were free of Salmonellae on follow up (11-24 weeks). Two developed recurrence of paratyphoid fever, 17 days and 4 months after therapy.

Adult↗
PubMed1992

Characterisation of non-01 Vibrio cholera isolated from stools of diarrhoeal patients.

A characterisation of the biochemical and physiological properties of 30 strains of non 01 V. cholerae isolated from faecal samples, was undertaken. The strains consistently expressed a large number of characters that define them to be closer to the El Tor biotype than their classical counterparts. They did not show much heterogeneity in their cultural and biochemical properties. The strains were strongly haemolysing (100%), haemagglutinating (96%) and also salt-tolerant, thereby acquiring a unique taxonomic status.

Diarrhea↗
PubMed1992

Occurrence of multiple antimicrobial resistance among Haemophilus influenzae type b causing meningitis.

Among the 157 children with culture proven pyogenic meningitis who were admitted during 1987-1991, in the Department of Child Health at the Christian Medical College and Hospital, Vellore, 40 had H. influenzae type b (HIB) meningitis; 17 of these had multiantimicrobial resistant HIB (MRHIB) and 23 others had usual susceptibility HIB (USHIB) meningitis. The two groups were compared. Children with MRHIB meningitis who received optimal treatment with cefotaxime had excellent recovery. When cefotaxime therapy was delayed, mortality was noted in all except one child who survived with severe neurological sequelae. MRHIB meningitis treated with drugs other than cefotaxime had 100 per cent mortality. Cefotaxime is therefore recommended in children below 3 yr of age presenting with purulent meningitis, as MRHIB is a possible causative agent in this group.

Anti-Bacterial Agents↗
PubMed1992

Biological characterisation of group F streptococci causing human infections.

Fifty five strains of group F streptococci (GFS) isolated from clinical samples of 53 patients with diverse diseases, were characterised by a battery of physiological tests. Among them 37 (67%) were Streptococcus anginosus F, 14 (25%) were Strep. intermedius, two of which were mannitol positive and 4 (7%) were Strep. constellatus. Determination of minimum inhibitory concentrations of penicillin, erythromycin, ampicillin, gentamicin and cefazolin showed that despite their biochemical heterogeneity, all strains were uniformly susceptible to these antibiotics. Except for bacteraemia, other diseases due to GFS responded well to surgical drainage and/or antibiotics.

Bacteremia↗