Laboratory Diagnosis of Bacterial Vaginosis and Potential Pathogens Other Than Group B Streptococcus in Vaginal Swab of Pregnant Women in Dhaka Medical College Hospital.

Pathogenic microorganisms are important cause of maternal and neonatal infections which are transmitted from colonized vagina of mother. The purpose of the present study was to detect the potential pathogens other than Group B Streptococcus in vaginal swab of pregnant women. This prospective cross sectional study was conducted from July 2013 to June 2014 at Dhaka Medical College Hospital, Dhaka, Bangladesh. A total of 224 vaginal swab samples were studied. Gram stain Nugent score was applied for all vaginal smear to detect bacterial vaginosis. Organisms were isolated and identified by wet film microscopy, Gram stain, biochemical tests, culture and PCR. Toxic shock syndrome toxin-1 gene and drug resistance genes such as mecA, vanA, vanB were detected among isolated Staphylococcus aureus. Antimicrobial susceptibility was done by disc diffusion method. Double disc synergy test was used to detect ESBL (Extended spectrum beta lactamases) producers. MIC (Minimum inhibitory concentration) of oxacillin and vancomycin were done for Staphylococcus aureus to detect MRSA (Methicillin resistant Staphylococcus aureus) and VRSA (Vancomycin resistant Staphylococcus aureus). Of the 224 samples, 44(19.64%) were Staphylococcus aureus, 22(9.8%) were Escherichia coli. Bacterial vaginosis was found in 12(5.36%) cases. Among the 9(21.43%) phenotypically identified ESBL producers, 4(18.18%) were Escherichia coli, 2(25%) were Klebsiella pneumoniae. Ninety six percent and 91% of the Escherichia coli were sensitive to colistin and imipenem. All the Klebsiella spp. was sensitive to colistin and all the Proteus spp. and the Pseudomonas aeruginosa were sensitive to imipenem and colistin. Of the 44 Staphylococcus aureus, 5(11.36%) were MRSA, 2(4.54%) were VRSA, 2MRSA were PVL gene positive and 2(4.54%) were positive for TSST-1 gene by PCR. All the isolated MRSA and VRSA were sensitive to linezolid. One of the two VRSA strains had MIC of vancomycin 64µg/ml and another had 128µg/ml. VRSA strains were positive for vanB gene, no VRSA was positive for vanA gene. Vaginal ecosystem study with the detection of pathogens can be helpful in the prevention of preterm delivery, premature rupture of membrane, chorioamnionitis, neonatal, puerperal and maternal-fetal infections.

Detection of Group B Streptococcus in Vaginal Swab of Pregnant Women by Culture and PCR and Their Antibiotic Susceptibility Pattern in a Tertiary Care Hospital of Bangladesh.

Group B Streptococcus (GBS) is an important cause of neonatal infection and transmitted from colonized vagina of mother. The purpose of the present study was to see the status of GBS infection in pregnant women. This prospective cross sectional study was conducted from July 2013 to June 2014 at Dhaka Medical College Hospital, Dhaka, Bangladesh. Total 224 vaginal swab samples were studied. Organisms were isolated and identified by Wet film microscopy, Gram stain, biochemical tests, culture and PCR. Of the 224 samples, 46(20.53%) were GBS positive. Highest proportion (33.78%) of GBS was found in 20-29 years of age group. Regarding GBS positivity majority (43.47%) were second gravid, 82.60% in 35-37 weeks of pregnancy, 64.04% were from middle income group, 39.13% were oral contraceptive pill (OCP) users. Hundred percent GBS were sensitive to penicillin, ampicillin, ceftriaxone and vancomycin. Most (46.43%) of the GBS were resistant to gentamycin followed by 35.72% to doxycycline and 28.57% to chloramphenicol. The sensitivity of PCR was 100%. Prevalence of GBS colonization was 20.53% among the pregnant women of Dhaka Medical College Hospital signifies GBS infection might be a silent clinical problem.

Rydberg Molecules for Ion-Atom Scattering in the Ultracold Regime.

We propose a novel experimental method to extend the investigation of ion-atom collisions from the so far studied cold, essentially classical regime to the ultracold, quantum regime. The key aspect of this method is the use of Rydberg molecules to initialize the ultracold ion-atom scattering event. We exemplify the proposed method with the lithium ion-atom system, for which we present simulations of how the initial Rydberg molecule wave function, freed by photoionization, evolves in the presence of the ion-atom scattering potential. We predict bounds for the ion-atom scattering length from ab initio calculations of the interaction potential. We demonstrate that, in the predicted bounds, the scattering length can be experimentally determined from the velocity of the scattered wave packet in the case of ^{6}Li^{+}-^{6}Li and from the molecular ion fraction in the case of ^{7}Li^{+}-^{7}Li. The proposed method to utilize Rydberg molecules for ultracold ion-atom scattering, here particularized for the lithium ion-atom system, is readily applicable to other ion-atom systems as well.

Use of Ber-EP4 and Epithelial Specific Antigen to Differentiate Clinical Simulators of Basal Cell Carcinoma.

EpCam is a transmembrane epithelial adhesion molecule present on all non-squamous epithelial cells. It is often overexpressed in certain carcinomas, such as breast and colon, and in dermatology, eg, basal cell carcinoma (BCC). Various monoclonal antibodies have been used to detect EpCam, including BerEP4 and epithelial specific antigen. We compared anti-EpCam clones, BerEP4, and epithelial specific antigen clone VU-1D9. One hundred and twelve lesions were stained with both antibodies. All basal cell carcinomas stained uniformly and strongly positive with both antibodies. Diffuse positive staining was also seen in all trichoepitheliomas and merkel cell carcinomas. Focal positive staining was seen in squamous cell carcinoma and benign sebaceous neoplasms. Clone VU-1D9 was more likely to produce focal positive staining as compared to BerEP4. This focal positive staining of sebaceous neoplasms and squamous cell carcinomas is a potential diagnostic pitfall.

Measurement of antibodies to pneumococcal, meningococcal and haemophilus polysaccharides, and tetanus and diphtheria toxoids using a 19-plexed assay.

The measurement of antibody responses to vaccination is useful in the assessment of immune status in suspected immune deficiency. Previous reliance on enzyme-linked immunoabsorbent assays (ELISA) has been cumbersome, time-consuming and expensive. The availability of flow cytometry systems has led to the development of multiplexed assays enabling simultaneous measurement of antibodies to several antigens. We optimized a flow cytometric bead-based assay to measure IgG and IgM concentrations in serum to 19 antigens contained in groups of bacterial subunit vaccines: pneumococcal vaccines, meningococcal vaccines, Haemophilus influenzae b (Hib), and tetanus and diphtheria toxoid vaccines. 89-SF was employed as the standard serum. The assay was used to determine specific antibody levels in serum from 193 healthy adult donors. IgG and pneumococcal IgM antibody concentrations were measurable across 3 log10 ranges encompassing the threshold protective IgG antibody levels for each antigen. There was little interference between antibody measurements by the 19-plexed assay compared with monoplexed assays, and a lack of cross-reactive IgG antibody, but evidence for cross-reacting IgM antibody for 3/19 pneumococcal antigens. 90th centile values for 15/19 IgG concentrations and 12/12 IgM concentrations of the 193 adult sera were within these ranges and percentages of sera containing protective IgG antibody levels varied from 4% to 95% depending on antigen. This multiplexed assay can simultaneously measure antibody levels to 19 bacterial vaccine antigens. It is suitable for use in standard clinical practice to assess the in vivo immune response to test vaccinations and measure absolute antibody levels to these antigens.