Diagnostic usefulness of transtracheal aspiration in lower respiratory tract infections

Background: The incidence of pulmonary infections is on a constant rise. The present study was undertaken in order to identify those patients in whom transtracheal aspiration is most likely to provide information not obtainable from evaluation of expectorated sputum and delineates the clinical conditions under which transtracheal aspiration is indicated.Methods: A total of 50 patients of lower respiratory tract infections were studied. Both sputum and trans-tracheal aspirate samples were compared by Gram’s stain and culture methods.Results: Gram’s staining of the sputum was non-helpful in most cases as it showed mixed organisms while trans-tracheal aspiration showed only single type of colony. Culture showed less growth in sputum samples as compared to trans-tracheal aspirates.Conclusions: Trans-tracheal aspirate appears to be a very good method for isolating infective agents in lower respiratory tract infections. Besides by passing the contaminants of the oropharynx, it pinpoints the organism in most cases

Strategies to provide care to Non-COVID Patients in the COVID Era: An Experience from a Tertiary Care Institute in Northern India

With the COVID-19 pandemic the health system is facing dual burden of cases, one being the COVID-19 or Severe Acute Respiratory Illness (SARI) cases and the second being the other Non-COVID cases. The Non-COVID cases due to the burden of the SARI cases became almost neglected by the Health System increasing the sufferings of the Non-COVID cases. In the current COVID times All India Institute of Medical Sciences, Gorakhpur continued to provide the health care to the Non-COVID cases. The current manuscript provides the detailed strategy and results of the various strategies used to provide care to such Non-COVID patients with minimum risk to the healthcare staff

A case of albendazole and niclosamide resistant Taenia saginata infection

Taenia saginata infection is an important food-borne parasitic zoonosis which is endemic in countries where majority of people eat raw or inadequately cooked beef. The infection is rare in India except in Jammu Kashmir and Northeast states, India. Majority of taeniasis patients are asymptomatic, few may present with a variety of abdominal symptoms and rarely hepatobiliary complications. Diagnosis is made commonly by finding proglottids and or eggs in the faeces.  Here we report a chronic and uncomplicated case of saginata taeniasis resistant to niclosamide and albendazole but responded to a single dosage of praziquantel 15 mg per Kg body weight

BACTERIOLOGICAL PROFILE AND ANTIBIOTIC SENSITIVITY PATTERN OF HOSPITALACQUIRED SEPTICEMIA IN A TERTIARY CARE HOSPITAL IN NORTH EAST INDIA

Objective: The objective of this study was to determine the bacterial agents responsible for hospital acquired septicaemia and to determine the antibiotic sensitivity profile of the bacterial isolates.Methods:  Three hundred fifty hospitalized clinically suspect septicaemia cases were included in this cross sectional observational study during a period of one year. Blood samples were collected with aseptic precautions for culture following universal precautions. Anti-microbial susceptibility test of the bacterial isolates was performed according to Clinical and Laboratory Standards Institute (CLSI, USA) guidelines.    Results: Over two-thirds of cultures showed gram positive organism. The most frequently identified Gram positive bacteria were coagulase negative staphylococci and Staphylococcus aureus. Among gram negative bacteria Escherichia coli, Klebsiella spp and Salmonella typhi were isolated. In our study, coagulase negative staphylococci showed maximum resistance to penicillin and erythromycin. Enterobactereciae had maximum sensitivity to carbapenems, tigecycline and aminoglycosides.Conclusion: Gram positive pathogens predominated in the blood stream infections. Résistance to fluoroquinolones, especially in Gram negative bacteria was significantly high. Therefore, rapid microbiological diagnosis and the determinants of antimicrobial susceptibility become relevant for early initiation of antimicrobial therapy.    Â

Group A streptococcal infection in the United Kingdom: an emerging threat

Within group A Streptococcus (GAS), only Streptococcus pyogenes exhibits clinical significance. GAS is typed serologically based on unique surface proteins and critical virulence factors, such as a hyaluronic acid capsule that shields GAS from phagocytosis. The burden of GAS was estimated in the last five years as 14,000 to 25,000 cases of the invasive group A streptococcal disease in the USA with an estimated death from 1,500 to 2,300 cases per year. Early in the summer of 2022 in England, there was more scarlet fever than was anticipated. Early in the current season, the number of notifications rose to unusual heights. The analysis of invasive GAS (iGAS) isolate typing data shows that this season has seen a wide variety of encoding mature M protein (emm) gene sequence types found. Therefore, public health authorities should think about initiatives to increase clinicians’ and the general public’s awareness of GAS infections and to promote their quick diagnosis, molecular testing and antibiotic susceptibility testing, and standard treatment

Virulence traits and novel drug delivery strategies for mucormycosis post-COVID-19: a comprehensive review

The outbreak of a fatal black fungus infection after the resurgence of the cadaverous COVID-19 has exhorted scientists worldwide to develop a nutshell by repurposing or designing new formulations to address the crisis. Patients expressing COVID-19 are more susceptible to Mucormycosis (MCR) and thus fall easy prey to decease accounting for this global threat. Their mortality rates range around 32-70% depending on the organs affected and grow even higher despite the treatment. The many contemporary recommendations strongly advise using liposomal amphotericin B and surgery as first-line therapy whenever practicable. MCR is a dangerous infection that requires an antifungal drug administration on appropriate prescription, typically one of the following: Amphotericin B, Posaconazole, or Isavuconazole since the fungi that cause MCR are resistant to other medications like fluconazole, voriconazole, and echinocandins. Amphotericin B and Posaconazole are administered through veins (intravenously), and isavuconazole by mouth (orally). From last several years so many compounds are developed against invasive fungal disease but only few of them are able to induce effective treatment against the micorals. Adjuvant medicines, more particularly, are difficult to assess without prospective randomized controlled investigations, which are challenging to conduct given the lower incidence and higher mortality from Mucormycosis. The present analysis provides insight into pathogenesis, epidemiology, clinical manifestations, underlying fungal virulence, and growth mechanisms. In addition, current therapy for MCR in Post Covid-19 individuals includes conventional and novel nano-based advanced management systems for procuring against deadly fungal infection. The study urges involving nanomedicine to prevent fungal growth at the commencement of infection, delay the progression, and mitigate fatality risk

Cryptococcus gattii meningitis in a diabetic adult in South India

Cryptococcosis is the opportunistic infection usually seen in immunocompromised individuals. Among human immunodeficiency virus (HIV)–seropositive participants, cryptococcal meningitis is the second most common cause of opportunistic neuro-infection, but at times, it occurs in non-HIV patients who are immunodeficient due to other reasons like chronic glucocorticoid use, organ transplantation, malignancy, and sarcoidosis and has rarely been described in diabetic patients. We present a fatal case of Cryptococcus gattii meningitis in a 56-year-old HIV-negative male patient with diabetes mellitus

Outbreak of an emerging zoonotic Nipah virus: An emerging concern

The Nipah virus (NiV) infection is one of the newly emerging deadly zoonotic diseases which carries a significant weightage of mortality among its victims. Due to the relatively recent history of its emergence and only a few known outbreaks, we cannot predict but foresee its potential to create havoc, which can be far more dreadful than the current ongoing COVID-19 pandemic. Here we have tried to depict the fatal potential of the virus and the increased propensity with which it can spread to rest of the world

Concomitant Mucormycosis with Aspergillosis in Patients with Uncontrolled Diabetes Mellitus: A Case Series

Fungal infections are life threatening especially in presence of immunosuppression or uncontrolled diabetes mellitus mainly due to their invasive potential. Mucormycosis of the oculo-rhino-cerebral region is an opportunistic, aggressive, fatal and rapidly spreading infection caused by organisms belonging to Mucorales order and class Zygomycetes. The organisms associated are ubiquitous. Aspergillosis is a common clinical condition caused by the Aspergillus species, most often by Aspergillus fumigatus (A. fumigatus). Both fungi have a predilection for the immunosuppressive conditions, with uncontrolled diabetes and malignancy being the most common among them. Mucormycosis is caused by environmental spores which get access into the body through the lungs and cause various systemic manifestations like rhino-cerebral mucormycosis. Here, a case series of such concomitant infections of Aspergillus and Mucor spp from Rishikesh, Uttarakhand, India is reported