Detection of phospholipase activity of Candida albicans and non albicans isolated from women of reproductive age with vulvovaginal candidiasis in rural area.

Background: Vulvovaginal candidiasis (VVC) is most common accounting for 17 to 39% of symptomatic women. Both Candida albicans and non albicans Candida species are involved in VVC. Amongst various virulence factors proposed for Candida, extracellular phospholipases is one of the virulence factor implicated in its pathogenicity. With this background the present study was carried out to fi nd the prevalence of different Candida species and to detect phospholipase producing strains isolated from symptomatic women with VVC. Materials and Methods: At least two vaginal swabs from 156 women of reproductive age with abnormal vaginal discharge were collected. Direct microscopy and Gram’s stained smear examined for presence of budding yeast and pseudo mycelia followed by isolation and identifi cation of Candida species. Extracellular phospholipase activity was studied by inoculating all isolates on Sabouraud’s dextrose egg yolk agar (SDA) medium. Results: Of the 156 women with curdy white discharge alone or in combination with other signs, 59 (37.82%) women showed laboratory evidence of VVC. A total of 31 (52.54%) women had curdy white discharge followed by 12 (20.33%) with other signs and symptoms. C. albicans (62.59%) and non albicans Candida (37.28%) in a ratio of 1.68:1 were isolated. Of the 37 strains of C. albians 30 (81.08%) showed the enzyme activity. Seventeen (56.66%) strains showed higher Pz value of < 0.70 (++++). Conclusion: Although there may be typical clinical presentation of Candidiasis. all the patients did not show laboratory evidence of infection. Pregnancy was found to be major risk factor for development of VVC. C. albicans was prevalent species but non albicans species were also frequently isolated. Extracellular phospholipase activity was seen in C. albicans and not in non albicans Candida isolates.

Clinical and laboratory evidence of Trichomonas vaginalis infection among women of reproductive age in rural area.

Background: Vaginitis is a commonly encountered complaint and one of the most frequent reasons for patient visit to obstetrician-gynaecologists. Three vaginal infections are frequent causes of a vaginal discharge: (1) bacterial vaginosis, (2) vulvovaginal candidiasis and (3) trichomonas vaginitis. Differences in the clinical presentation are helpful in diagnosis. Characteristic signs and symptoms for these three vaginal infections are distinct, but on many occasions, they are overlapping. The aim of the present study was to find the prevalence and correlation between the clinical spectrum and laboratory evidence of Trichomonas vaginalis infection by simple, reliable, confirmatory and specific method, i.e. microscopic examination of wet mount preparation and acridine stain of vaginal fluid. Materials and Methods: Irrespective of HIV status, a total of 156 women with vaginal discharge were studied for establishing diagnosis of genital tract infection. The cases of bacterial vaginosis and vulvovaginal candidiasis were excluded from the study. Vaginal speculum assisted high vaginal swabs were collected from women with discharge, during collection vagina was inspected for obvious signs. Results: Of the 156 women with vaginal discharge, 19 (12.06 %) showed T. vaginalis infection. All the women belonged to active reproductive age group, i.e. 20-40 years. Itching dysuria, and offensive, malodorous, thin, yellowish vaginal discharge were the main and consistent complaints. Only in 2 (1.52%) cases, vaginal speculum examination revealed erythema and punctuate haemorrhage, the so-called "strawberry' vagina. The pH was recorded to be >4.5. Conclusion: Clinical differentiation of various forms of infectious vaginitis is unreliable. The prevalence of T. vaginalis infection at 12.06% was found among rural young women of reproductive age using simple and reliable screening wet mount microscopy.

Mycological and serological study of pulmonary aspergillosis in central India.

PURPOSE: To study the prevalence and predisposing factors of Aspergillus infection and correlate microscopic, culture and serological findings along with drug sensitivity. METHODS: Sputum samples from 123 patients of pulmonary disease with clinical suspicion of having fungal, especially Aspergillus infections, were examined microscopically and for culture. Minimum inhibitory concentration (MIC) of itraconazole was tested against the isolates. Serum samples from these patients were tested for precipitin against Aspergillus antigen using immunodiffusion (ID) technique. RESULTS: Aspergillus species were isolated in 20 (16.26%) cases and Aspergillus fumigatus was the predominant species isolated in 16 (80%) cases. Precipitins were detected in 29 (23.58%) cases. Serum samples collected from 50 healthy individuals to serve as controls showed no precipitin against Aspergillus antigen galactomannan. This fungus was found to be sensitive to itraconazole with MIC range 0.125-1microg/mL. CONCLUSIONS: Serological tests have an edge over routine smear and culture methods for the diagnosis of pulmonary aspergillosis. Itraconazole is more effective than amphotericin B and fluconazole in the treatment of aspergillosis.

Change in antimicrobial resistance pattern of Salmonella Typhi in central India.

BACKGROUND & OBJECTIVES: Multidrug resistant Salmonella Typhi infections have been reported worldwide in the last decade. In a study from central India in 1991 multidrug resistant S. Typhi were reported to account for 91 per cent of patients of enteric fever. The present study was planned to study the antimicrobial susceptibility pattern, phage types and biotypes of strains of S. Typhi prevalent in this region. METHODS: A total of 54 isolates of Salmonella were recovered from 1468 blood samples of patients suspected to have enteric fever and admitted in the Government Medical College and Hospital, Nagpur. Antimicrobial susceptibility pattern of these isolates was studied by disc diffusion test. Phage typing and biotyping of the first 33 strains was done at the National Salmonella Phage Typing Center, New Delhi. Minimum inhibitory concentration of chloramphenicol was determined by agar dilution method. RESULTS: Of 54 isolates of Salmonella, 51(94%) were S. Typhi and 3 (6%) were S. paratyphi A serotype. Of the 30 isolates of S. Typhi subjected to phage typing, two phage types E1 23 (77%) and A 7 (23%) were found to be prevalent in this region. Multidrug resistance was observed in 12 (22%) strains of S. Typhi. Thirty five (68%) strains were sensitive to chloramphenicol, ampicillin, gentamicin, cotrimoxazole, cefotaxime and ciprofloxacin. Resistance to two antibiotics was observed in 4 (8%) strains. Cefotaxime resistance was observed in one isolate and gentamycin resistance in two, while none of the isolates was found to be ciprofloxacin resistant. INTERPRETATION & CONCLUSION: Multidrug resistance in S. Typhi has decreased from that reported in 1991 though there is a still a small percentage of strains which continue to be multidrug resistant.

Study of proteases and other enzymes of Vibrio cholerae 01 E2 Tor and 0139 serotypes isolated in Yavatmal (Maharashtra).

V. cholerae 01 E1 Tor isolated during Cholera epidemic of 1994 and V cholerae 0139 serotype isolated during 1993 epidemic were subjected to the study of proteases and other enzymes. Out of 26 strains of V. cholerae 01 studied, gelatinase and caseinase activity was seen in 100 and 69.23 percent strains respectively. All strains showed catalase and oxidase activity. Of the other enzymes studied 19.23, 65.38 and 57.69 percent strains were positive for DNAse, lipase and phosphatase respectively. None of the strains showed lecithinase activity. Similar findings were observed in 22 strains of V. cholerae 0139 except all strains were positive for phosphatase activity. Role of enzymes in virulence is suggested.

Re-emergence of Vibrio cholerae serogroup O139 during June-August, 1997 in Yavatmal (Maharashtra).

A clone of V. cholerae serogroup O139 which emerged as a novel epidemic strain, was reported from this region in 1993 as from many other parts of India and adjoining countries. The decline in the isolation rate of this organism in subsequent years was followed by a sudden increase in 1997, this requires careful monitoring.

Changing pattern of Vibrio cholerae serotype EL TOR and 0139 in Yavatmal (Maharashtra, India) during 1992 to 1994.

During 1992, 1993 and 1994 a total of 65, 123 and 142 faecal samples respectively yielded 9, 54 and 87 strains of V. cholerae. Simultaneous occurrence of EL TOR vibrio and non 01 (i.e. 0139) was noted during 1993 and 1994 with variations in relative and absolute prevalence of each serotype. Seasonal incidence is fairly consistent in this region. Both V. cholerae serotypes 01 and 0139 showed resistance to one or more drugs.

Study of pathogenicity markers of staphylococci isolated from clinical specimens.

A total of 165 strains of coagulase positive staphylococci (CPS) and 39 strains of coagulase negative Staphylococci (CNS) isolated from various clinical specimens studied for biochemical and enzyme profile showed overlapping of the key characters of pathogenicity. Anaerobic mannitol fermentation (69.20%), phosphatase (58.97%) and penicillinase (58.97%) production was remarkable amongst CNS. Both CPS and CNS showed increased resistance to penicillin and other antimicrobials. Besides increased frequency of isolation of CNS from pathological specimens, they elaborate singly or in combination, the recognized virulence factors.

Outbreak of food poisoning due to Salmonella paratyphi A var durazzo (2,12:a:-) in Yavatmal (Maharashtra) in May 1995.

Thirty three patients presented with acute diarrhoea and vomiting, 12-24 h after consuming vegetarian food. Twenty three patients developed high grade fever, with two patients developing complications. Salmonella paratyphi A var durazzo was isolated from 12 faecal samples. This serovar of Salmonella as a causative organism of food poisoning is unusual.

Primary cutaneous disease due to Nocardia asteriodes--a case report.

A case of primary cutaneous nocardiosis on abdominal wall, caused by Nocardia asterides is reported here. The site and the organism are both rarely encountered. The patient responded to sulphonamide treatment.

Study of bacteraemia using conventional and biphasic culture methods.

A total of two hundred blood samples collected from patients presenting with febrile illness were followed by culture using traditional and biphasic culture methods. Use of biphasic medium was observed to be of dual advantage as it grew pathogens earlier (28.5 percent in 18 hours, 63 percent in 36 hours of incubation) as well as in more number of cultures i.e. higher isolation rate (78 percent) when compared to traditional method.

Outbreak due to Vibrio cholerae E1 Tor & serotype O139 in Yavatmal (Maharashtra) during June-July, 1994.

A total of 65 strains of V. cholerae were isolated during June-July 1994 at Yavatmal (Maharashtra). Of the 65 strains isolated, 62 were 01 El Tor Vibrios, while three were non 01 serotype 0139. The novel epidemic strain designated as 0139 reported during the outbreak in 1993, has been supplanted by the usual El Tor Vibrio during the present outbreak while 0139 serotype has remained sporadic.

Cholera outbreak due to Vibrio cholerae serogroup 0139 in Yavatmal (Maharashtra) in March-July, 1993.

A total of 34 strains of V. cholerae were isolated during March to July, 1993. Of the 34 V. cholerae isolated 26 strains were non 01 and remaining eight were 01 El tor vibrio. Non-01 strains were identified as novel epidemic strains designated as 0139. The shift in the relative and absolute prevalence of V. cholera serotype 01 and non 01 was noted.