The first epidemic of Vibrio cholerae O139.
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Cholera↗
Biomedical subjects
M V Jesudason
Publications and source records attributed to M V Jesudason.
C substance--specific latex agglutination for early & rapid detection of Streptococcus pneumoniae in blood cultures.
A slide agglutination test was developed using latex particles coated with antiserum against the C substance, a common antigen for all serotypes of Streptococcus pneumoniae. This test was used for the rapid identification of pneumococci in blood culture broths which contained Gram positive cocci (GPC) in pairs or short chains on smear examination. Of 238 consecutive blood cultures with GPC tested, 72 were positive for Strep. pneumoniae by the latex test and conventional methods. The remaining 166 cultures were negative for both these, indicating a 100 per cent specificity and sensitivity for the test.
Antigens, Bacterial↗
Ceftazidime resistance among Klebsiella pneumoniae in south India.
Fifteen strains of K. pneumoniae resistant to ceftazidime were tested for extended spectrum beta lactamase (ESBL) production by double disc diffusion synergy test using ceftazidime and augmentin, and by testing for reduction in minimum inhibitory concentration of ceftazidime in combination with clavulanic acid. All strains were found to produce ESBL. We document the presence of ESBL producing strains in south India. There is a possibility of the spread of this resistance to other bacteria because the resistance could be transferred to recipient Escherichia coli from two strains.
Ceftazidime↗
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↗
Reappearance of Vibrio cholerae O1 and concurrent prevalence of O1 and O139 in Vellore, South India.
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Cholera↗
Vi-specific latex agglutination for early and rapid detection of Salmonella serotype typhi in blood cultures.
Latex particles coated with rabbit antisera against Salmonella serotype typhi (S. typhi) Vi and O (STO) antigens were used in slide agglutination tests for the rapid identification of S. typhi in blood culture broths as soon as Gram-negative bacilli (GNB) were detected in them. Among 231 consecutive blood cultures showing GNB tested for Vi, and a subset of 163 tested for STO, by latex agglutination (LA), 125 and 32, respectively, were positive. The GNB in 127 blood cultures were confirmed by conventional methods as S. typhi, 125 (98.4%) of which had been identified by the Vi LA test. In the subset of 163, 81 grew S. typhi, of which only 32 (39.5%) had been identified by the STO LA tests. Thus, the sensitivity of the Vi and STO LA tests was 98.4% and 39.5%, respectively, whereas the specificity was 100% for both tests. Of the S. typhi isolates, 38 (30.4%) were detected by the Vi LA test on day 2 and 73 (58.4%) on day 3, day 1 being the date of inoculation of the blood culture broths. Thus, the Vi LA test is suitable for the early and rapid confirmation of S. typhi in blood culture.
Agglutination Tests↗
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↗
The appearance & spread of Vibrio cholerae 0139 in India.
A new clone of non-01 V. cholerae designated as serogroup 0139, which produces cholera toxin, was detected first in south India in September 1992 and has spread to many parts of India since then. It was identified in Bangladesh in December 1992 and in Thailand in April 1993. By May 1993 it was found in Haryana and Punjab. Its clinical manifestations are typical of cholera, occurring in outbreaks. This clone has largely replaced the previously prevalent 01 V. cholerae in several cholera endemic areas indicating that a new cholera pandemic has begun.
Cholera↗
Blood stream invasion by Vibrio cholerae O139.
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Bacteremia↗
Major shift in prevalence of non-O1 and El Tor Vibrio cholerae.
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Cholera↗
Dissemination of the TEM-I beta-lactamase gene into disparate plasmids in faecal strains of Escherichia coli isolated in Vellore, south India.
The genetic basis for ampicillin resistance in commensal strains of Escherichia coli isolated in Vellore, south India has been examined. Of the 58 strains tested, 41% could transfer ampicillin resistance to a standard E. coli host strain. With the exception of one isolate, transferable ampicillin resistance was shown to result from the presence of the TEM-I beta-lactamase which was found on a wide variety of plasmid types.
Ampicillin Resistance↗
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↗
A simple method to prepare Salmonella (A-E) polyvalent antiserum.
The preparation of Salmonella O serogroup (A-I) polyvalent antiserum is laborious. In an alternate method, rabbit antiserum raised to cell surface proteins of Salmonella serotype typhi was compared with a commercial Salmonella polyvalent (A-I) antiserum; 51 Salmonella (A-E) and 16 strains of related organisms tested gave comparable agglutination with both sera.
Bacteriological Techniques↗
Resistance of shigella to nalidixic acid & fluorinated quinolones.
It is known that nalidixic acid resistance is a relatively rare phenomenon among shigellae. Between June 1989 and May 1990, six strains of shigellae resistant to nalidixic acid were isolated. These strains also exhibited resistance to three newer fluoroquinolones, viz., ciprofloxacin, pefloxacin and enoxacin. In repeated experiments, nalidixic acid resistance did not transfer to a suitable recipient.
Anti-Infective Agents↗
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↗
The incidence of antibiotic resistance in aerobic faecal flora in south India.
During a field study in South India in 1989, faecal specimens were collected from residents in villages and the town of Vellore in South India. Examination of the faecal specimens revealed that virtually the whole population carried commensal bacteria resistant to trimethoprim, ampicillin and chloramphenicol. Most specimens contained more than one type of bacterium resistant to each antibiotic. There was less resistance to nalidixic acid, with a higher proportion in the town (33%) than in the villages (13%). Although there was little cross-resistance of the ampicillin-resistant strains to later generation cephalosporins, 50% were resistant to the combination of amoxycillin and clavulanic acid. There was no significant cross-resistance of the nalidixic acid-resistant strains to fluorinated 4-quinolones, despite the free availability of ciprofloxacin and norfloxacin in the area. The probable reason for the high incidence of resistance to first generation antimicrobials is the extensive use of these agents, coupled with continuous exposure to large numbers of faecal micro-organisms.
Bacteria, Aerobic↗
Evaluation of modified passive haemagglutination assay for Vi antibody estimation in Salmonella typhi infections.
A simple passive haemmagglutination assay (PHA) was developed to detect Vi antibodies, to improve the diagnosis of typhoid fever by small laboratories. The Vi capsular antigen of Salmonella typhi was extracted by alternate alcohol and acetone precipitation. Formalin fixed, sheep red blood cells treated with chromium chloride were sensitised with this Vi antigen and antibodies detected and measured by PHA. The test had a sensitivity of 83.3% among 30 cases of typhoid fever confirmed by culture. The specificity of the test was 94%, making it suitable for use in laboratories without facilities for IFAT or ELISA.
Antibodies, Bacterial↗
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↗