Biomedical subjects
Publications and source records attributed to P G Shivananda.
Pulmonary infection due to Trichosporon beigelii is uncommon. A case of Pneumonia in a 28 year old male patient with positive HIV status, secondary to Trichosporon beigelii is reported.
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Stethoscopes are an essential tool of the medical profession and can become a source of nosocomial infection. A study conducted in the Department of Pediatrics, Kasturba Medical College and Hospital showed a high carriage of methicillin resistant staphylococcus (69.76%) and multi-drug resistant Gram negative bacilli (20.93%) on regularly used stethoscopes. The antibiogram of the bacterial isolates strongly suggested these to be nosocomial strains. A verbal survey revealed that regular cleaning is not common among doctors. A policy regarding cleaning of stethoscopes with an effective disinfectant may be helpful in reducing hospital-associated infections.
This is the first case of Chromobacterium violaceum diarrhoea from coastal Karnataka reported in a 2 year 10 months old girl. Stool culture yielded Chromobacterium violaceum and was sensitive to ampicillin, gentamicin, chloramphenicol, erythromycin and septran. Patient completely recovered with ampicillin and gentamicin.
Antibiotic Susceptibility was performed on sixty clinical isolates of nonsporing anaerobes against ten antimicrobial agents. The test was performed on Muller Hinton Agar and Wilkins Chalgren blood agar by preparing suspension of freshly isolated colonies in BHI broth. Apart from Metronidazole and Chloramphenicol newer antibiotics like Minocycline, Secnidazole, Tinidazole, Clarithromycin, Roxithromycin were also tried. Antimicrobial agents like metronidazole, Secnidazole, Tinidazole and Minocycline were 100% sensitive, followed by Chloramphenicol, Clarithromycin and Roxithromycin. These newer agents can be good alternatives for the treatment of non sporing anaerobes.
Antibiotic susceptibility was performed on sixty clinical isolates of nonsporing anaerobes against ten antimicrobial agents. The test was performed on Muller Hinton Agar and Wilkins Chalgren blood agar by preparing suspension of freshly isolated colonies in BHI broth. Apart from Metronidazole and Chloramphenicol newer antibiotics like Minocycline, Secnidazole, Tinidazole, Clarithromycin, Roxithromycin were also tried. Antimicrobial agents like Metronidazole, Secnidazole, Tinidazole and Minocycline were 100% sensitive, followed by Chloramphenicol, Clarithromycin and Roxithromycin. These newer agents can be good alternatives for the treatment of non sporing anaerobes.
A 25 year old male student presented with a discharging sinus and swelling over right forearm, which on culture yielded S. typhi, sensitive to Ciprofloxacin. Predisposing factors were absent but there was a history of surgery for chronic osteomyelitis of right ulna and injury with cricket ball at same site. Pus obtained during surgery was sterile. Patient responded to oral Ciprofloxacin. Soft tissue infections are uncommon manifestation of salmonellosis. This case is an unusual presentation of post-operative Salmonella typhi wound infection.
A case of Otitis media, a rare complication of Salmonella senftenberg infection is reported.
Coagulase negative Staphylococci (CONS) which were considered as laboratory contaminants and normal flora of skin in man, have emerged as opportunistic pathogens. The infection with CONS has been reported since 1950 with increasing frequency and has been implicated as the causative agents of certain categories of patients viz, neonates with sepsis, cardiac patients with prosthetic valves, immunocompromided patients which include end-renal stage disease, and renal transplantation, burns and cancer patient. These are causing problems to clinicians because of their drug resistance. 180 strains of CONS isolated from blood and CSF during the period of 2 years (Jan 1997-Dec 1998) were studied. Not only they were resistant to Penicillin (P), Ampicillin, (Amp), Oxacillin (Ox), but also developing resistance to Vancomycin (Van) which pose a therapeutic problem. So this study was undertaken and this area needs further exploration.
A study was conducted to ascertain the prevalence of copper resistant Salmonella typhi isolates in south Karnataka. Of the 186 strains studied, 26 (13.97%) were found to be copper resistant. Among the copper resistant strains 19 (73.08%) were found multi drug resistant. All copper resistant strains remained uniformly sensitive to ceftriaxone, ciprofloxacin and norfloxacin. Multiple drug resistance was exclusively associated with E1 phage types.
A slide Co-agglutination test for the detection of Salmonella typhi Vi antigen in blood was evaluated for its efficiency in rapid diagnosis of Typhoid fever. The results were compared with conventional methods like Blood culture and Widal test. The test showed a sensitivity of 86.67% and specificity of 88.83% when compared with blood culture positivity or Widal titre above 160. This is a useful rapid diagnostic test for the early diagnosis of Typhoid fever.
Cryptosporidium and isospora, two of the intestinal coccidian parasites known to be the causative agents of acute diarrhoea in animals, have now emerged as one of the main causes of prolonged life threatening diarrhoea in immunocompromised patients particularly so in patients with AIDS. Between June 1996 and December 1997, a total of 75 immunocompromised patients presenting with diarrhoea were investigated both for Cryptosporidium and Isospora. The study group consisted of cancer and AIDS patients with history of diarrhoea. Cryptosporidium oocysts were detected in 35 patients (46.7%). One of the faecal samples from an AIDS patient with diarrhoea showed the presence of both Cryptosporidium and Isospora oocysts. To the best of our knowledge, this is the second documented report of Isospora associated diarrhoea in an AIDS patient from India. The various techniques used for demonstration of these parasites were modified acid fast staining, Safranine Methylene-blue staining and direct immunofluorescence test.
Out of the 226 strains of S. typhi isolated over a period of three years 57.9% of them were multidrug resistant. 8.8% of the isolates were sensitive to all the drugs tested. A significant decline in hte number of multidrug resistant strains was observed in this region. Majority of the isolates belonged to phage type E (75.7%) and Biotype 1 (93.8%). All strains isolated were sensitive to ciprofloxacin, norfloxacin and ceftriaxone.
An unusual case of Flavobacterium meningosepticum pneumonia in an immunocompromised patient is reported. The necessity to recognize this opportunistic pathogen and its implication is discussed.
Meloidosis in a unusual site has been reported in a child. Complete identification of the organism has been presented.
A total of 406 post-operative clean wounds were studied for the presence of sepsis and antibiogram of organisms were established. The over all post-operative sepsis rate was 13% (clinical) and 12% (bacteriological). Staphylococcus aureus (32%) and Pseudomonas species (21%) were the commonest organisms recovered and Netilmycin, Cephaloridine and Norfloxacin were the most effective antibiotics against both Gram positive and negative infections. This study reflects the change in pattern of infecting bacterial flora in case of post operative wound infections and its antibiogram.
A five day old female baby was admitted with distension of abdomen since birth and nonbilious vomiting, fever of one day duration. Blood culture grew Klebsiella pneumoniae. Abdominal exploration revealed thick walled cavity containing purulent fluid grew klebsiella pneumoniae which was sensitive to various antibiotics including gentamycin. The child was treated with injection gentamycin and ceftazidime. The child had uneventful recovery and is doing well 3 years post operatively.