Molecular characteristics of infection and colonization isolates of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA)

Staphylococcus aureus is a gram-positive coccus that colonizes the skin and mucous membranes, particularly the anterior nares. Recently, community-acquired MRSA (CA-MRSA) has emerged as a cause of skin and soft-tissue infections in healthy individuals. These strains are sensitive to antimicrobials, carry genes for Panton-Valentine leukocidin (PVL) toxin, and feature the staphylococcal cassette chromosome mec (SCCmec) type IV or V. The suspected mode of transmission involves close contact with carriers, leading to skin or nasal colonization that results in subsequent active infection. This study was undertaken to determine the molecular characteristics of CA-MRSA isolates in children presenting with wound infections at Likas Hospital, Sabah, Malaysia, and the possible mode of transmission. The results showed that the majority of CA-MRSA infection isolates were from scalp abscesses (49%) in 1–5-year-old children (70%) in the Filipino (54%) community. The presence of the mec gene was detected in all isolates and the PVL virulence factor was found in 92% of the isolates. SCCmec typing revealed that 57% of the isolates were untypable, 35% harbored the SCCmecIVa element, and one each had SCCmecIVc, SCCmecV, or SCCmecII. Sixteen S. aureus strains were isolated from nasal swabs in 19 family members of index patients. Fourteen of these cultures were positive for catalase, coagulase, and DNAase. All of the colonization isolates carried the mecA gene and only a third were positive for the PVL toxin. SCCmec typing showed that 79% of the isolates were untypable and two had SCCmecIVa element and one had SCCmecV element. When five pairs of infection and colonizing isolates were compared by spa typing, only two pairs showed identical spa type with possible transmission between the patient and family contact. Further studies are necessary to establish CA-MRSA transmission by performing multiple-site cultures multiple times instead of one-time naresonly sample collection

Study of association of serum vitamin D and serum calcium with spontaneous aneurysmal subarachnoid haemorrhage in a tertiary care centre

Background: Aneurysmal subarachnoid haemorrhage (aSAH) is a disease associated with high mortality and morbidity. Recent studies have postulated a correlation between Vitamin D deficiency and aSAH, however, the mechanism of which remains obscure. Vitamin D and Calcium in patients withaSAH has not been formally investigated. Therefore, the aim of this study was to evaluate the incidence of hypovitaminosis D and hypocalcemia in patients with aSAH. Methods: An observational study was conducted at the Department of Neurosurgery at tertiary care centre, New Delhi, India. 40 patients with spontaneous aneurysmal SAH were enrolled during the period January 2019 to 15th April 2020. The standard protocol of care was given to all patients included in the study. Laboratory investigations including Vitamin D and Calcium levels; Clinical examination and grading were done for each patient. The data thus collected was used to see the clinic-demographic profile of patients of aSAH with an emphasis on Vitamin D and Calcium levels. Results: The study reported mean vitamin D level of 17.4 ± 7 ng/ml; mean calcium level of 8.3 ± 0.9 mg/dl amongst the study participants. Out of 40 patients, 8 patients (20%) were severely deficient, 24 patients (60%) were mild to moderate deficient and 8 patients (20%) were having normal vitamin D levels. 50% of the patients (n=20) were hypocalcaemic and 50% were normocalcaemic. Conclusion:  A higher incidence of vitamin D deficiency was observed in our study along with an equal incidence of hypocalcemia vs normocalcemia. Further studies with a comparison group and a bigger sample size are needed to validate this evidence

Descriptive epidemiology of equine influenza in India (2008-2009): temporal and spatial trends

Equine influenza is a contagious viral disease that affects all members of the family Equidae, i.e. horses, donkeys and mules. The authors describe the pattern of equine influenza outbreaks in a number of states of India from July 2008 to June 2009. The disease was first reported in June 2008 in Katra (Jammu and Kashmir) and spread to ten other states within a year. All outbreaks of equine influenza in the various states were confirmed by laboratory investigations (virus isolation and/or serological confirmation based on haemagglutination inhibition [HI] assays of paired samples) before declaring them as equine influenza virus-affected state(s). The virus (H3N8) was reported from various locations in the country including Katra, Mysore (Karnataka), Ahmedabad (Gujarat), Gopeshwar and Uttarkashi (Uttarakhand) and was isolated in 9- to 11-day-old embryonated chicken eggs. The virus was confirmed as H3N8 by HI assays with standard serum and amplification of full-length haemagglutinin and neuraminidase genes by reverse transcriptase-polymerase chain reaction. Serum samples (n = 4 740) of equines from 13 states in India screened by HI revealed 1 074 (22.65%) samples as being positive for antibodies to equine influenza virus (H3N8)