Multilocus Sequence Typing of Clinical Isolates of Cryptococcus from India.

Cryptococcosis is a life-threatening infection caused by Cryptococcus neoformans and C. gattii species complex. In the present study, to understand the molecular epidemiology of 208 clinical isolates of Cryptococcus from different parts of India, multilocus sequence typing (MLST) using ISHAM MLST consensus scheme for C. neoformans/C. gattii species complex was used. MLST analysis yielded a total of 10 Sequence Types (STs)-7 STs for C. neoformans and 3 for C. gattii species complex. The majority of isolates identified as C. neoformans belonged to molecular type VNI with predominant STs 31 and 93. Only 3 isolates of C. gattii species complex were obtained, belonging to ST58 and ST215 of VGI and ST69 of VGIV. Phylogenetic analysis revealed less diversity among the clinical Indian isolates compared to the global MLST database. No association between prevalent STs and HIV status, geographical origin or minimum inhibitory concentration (MIC) could be established.

Are all patients diagnosed with tuberculosis in Indian medical colleges referred to the RNTCP?

To assess the proportion of tuberculosis (TB) patients diagnosed in three medical colleges in the states of West Bengal and Meghalaya who benefited from the services provided under the Revised National Tuberculosis Control Programme (RNTCP), a line list of patients with reports of investigations suggesting probable or confirmed TB was prepared from the records of the pathology, radiology and microbiology departments. This was compared with another line list prepared using RNTCP records. Only 150 (36%) of 420 probable or confirmed TB patients were referred to the RNTCP services. This suggests a need for more intensive supervision and training of medical college faculty.

A cholera epidemic in a rural area of northeast India.

Sporadic cases of acute diarrhoea with high morbidity occur commonly in rural areas of northeast India, throughout the year. At times they take epidemic form and one such outbreak occurred with attack and case fatality rates of 11.6% and 0.8%, respectively, in October 2002, in a remote locality of Assam. Vibrio cholerae O1 El Tor Ogawa was isolated in 63% of hospitalized acute diarrhoea patients. Ineffective antibacterial treatment, poor hygiene practices and bad peridomestic sanitation were the factors associated with the persistence and spread of the pathogen, leading to the outbreak of cholera, resistant to commonly-used antimicrobials.

Japanese encephalitis in Assam, northeast India.

Japanese encephalitis is one of the major public health problems in Assam, northeast India. We aimed to elucidated the clinical and epidemiological profile of the disease during several outbreaks in Assam in 3 consecutive years. Cerebro-spinal fluid and or serum samples of 348 out of 773 clinically-suspected viral encephalitis patients admitted to different hospitals during the period June to August of 2000 to 2002 were tested for detection of JE specific IgM antibody, employing MAC ELISA test at RMRC (ICMR), Dibrugarh. Diagnosis was confirmed in 53.7% patients with the ratios of 1.8:1 and 1.4:1 for male to female and pediatric to adult patients respectively. Most of the cases were pediatrics at the age of 7 to 12 years (34.2%). Fever (100%), altered sensorium (81.8%), headache (70.6%), neck rigidity (54.0%), abnormal movement (51.3%), exaggerated reflexes (48.1%), restlessness (44.9%), increased muscle tone (35.3%), convulsion (33.7%) and coma (20.9%) were the major clinical findings. The majority of cases (96.3%) were from rural areas. House surroundings close to water bodies, rice cultivation, association with pigs, and climatic conditions were environmental factors affecting the abundance of the potential mosquito vectors of the disease.

Emergence of novel human group A rotavirus G12 strains in India.

Three rare human G12 strains were detected from diarrheic clinical samples of children (<8 months of age) in Calcutta during a routine surveillance study of rotaviral diarrhea in India. The VP7 genes of G12 strains and their products showed maximum homology (97 to 99% at the nucleotide level and 98% at the amino acid level, respectively) with those of two recently reported G12 strains (from the United States and Thailand) but lesser homology with those of prototype G12 strain L26.

Antimicrobial susceptibility pattern among methicillin resistant Staphylococcus isolates in Assam.

Prevalence of methicillin resistant Staphylococcus aureus from a referral hospital in Assam was studied. Methicillin resistance among the Staphylococcus aureus isolates was 52.9% and 15% among the coagulase negative staphylococci. Resistance to all antibiotics tested among the methicillin resistant and methicillin sensitive staphylococci was found to be 23.2% and 6.6% respectively. Higher resistance to multiple antibiotics in methicillin resistant strains as compared to methicillin sensitive strains was found to be statistically significant. Ciprofloxacin resistance among the strains was still lower in comparison to the findings from other parts of the country.

HCV activity in an isolated community in north east India.

Prevalence of anti-HCV among the people at risk and general population were reported across the globe. We investigated HCV activity among the members of "Lisu" community settled in a remote and isolated area of Changlang District, Arunachal Pradesh during 1999-2000. The families were scattered with 380 households. Blood samples were collected from 76 (35 males and 45 females) apparently healthy individuals from randomly selected 10% families. Sera were processed for detection for antibody to HCV by using 3rd generation ELISA kit. All the persons were within the age of 18-98 years and 75% of them were uneducated and 92% were cultivators. The prevalence of anti-HCV was found to be very high (7.89%). Since the HCV activity is high in an isolated community, transmission dynamics study will be interesting for this epidemiologically important viral disease.

Bronchopulmonary candidiasis in a tertiary referral hospital of Assam, India.

One hundred patients with chronic chest infection suffering for more than three months admitted into a tertiary referral Hospital, northeast India were examined for pulmonary mycoses. The morning sputum samples in 3 consecutive days with a throat swab of each patient were examined for detection, isolation and identification of the fungus. Study showed Pulmonary candidiasis in 50% of the patients where Candida albicans were having highest incidence of association followed by 5 other species of Candida. Pre-existing conditions like pulmonary tuberculosis, bronchogenic carcinoma, lung abscess, bronchial asthma make the lungs prone to be invaded by the candida species. Long term antibiotics and steroids therapy was found to be associated with pulmonary candidiasis. Other conditions like irradiation treatment, malignancy, diabetes mellitus and malnutrition were also found to be the predisposing factors which influence bronchopulmonary candidiasis.