Candidemia in neonatal intensive care unit: a cause of concern

Background: Candidemia in neonates is a serious and common cause of late onset sepsis. Candida species are the third most frequent organism isolated in late onset sepsis in very low birth weight (VLBW) infants (i.e., <1,500 g). Methods: This study was performed to evaluate epidemiology, species distribution, antifungal susceptibility and outcome of candida blood stream infections at a tertiary care centre.Results: About 1-2 ml of blood was collected aseptically in suspected cases of septicaemia and inoculated in 20 ml of Brain Heart Infusion(BHI) broth. Candida species isolates were confirmed by germ tube production, chlamydospore formation on corn meal agar(HiMedia), pigmentation on Hichrome Candida differential agar (Himedia), and carbohydrate assimilation tests. Non-albicans candida spp. are of special concern, due to their high virulence and low azole susceptibility characteristics, augmenting the high mortality rates.Conclusions: The emergence on non-albicans Candida merits attention as they display higher degree of resistance to azoles and are associated with higher mortality rates. Additional studies are required to define more accurately the prevalence and sensitivity pattern of Candida spp. which may serve as a template for development of preventive and therapeutic strategies for neonatal candidemia especially at peripheral health centres

Outcome of routine testing for HCV and HBV in patients attending and admitted in various surgical units of a tertiary care institute

Background: Hepatitis B and C virus remain leading causes of morbidity and mortality. Unfortunately, once inflicted, these infections show poor response to the available treatment modalities. So the focus remains on preventive strategies, to avoid spread of infection. There is lack of routine serological screening prior to surgery which is one of the factors responsible for increased disease transmission. Material and Methods: The present study involved retrospective analysis of 9272 routine blood samples from all ages and both sexes who were attending and admitted in different surgical departments. These patients were screened by rapid immunochromatographic assay for qualitative detection of anti- HCV antibodies and HBsAg to know their carrier status prior to any surgical intervention. Results: Out of 9272 samples tested, 155 (3.6%) tested positive for anti- HCV antibodies and 162 (3.26%) for HBsAg. Seroprevalence of HCV was 3.77 %( 96) and 3.36% (59) in male and female respectively, with preponderance among age group of 41-60 (43.87%) and 21- 40 years (39.35%). HBsAg detection revealed seropositivity of 3.89 %( 93) in males; 2.67 %( 69) in females, with predominance in young adults of 21-40 (43.83%) followed by 41-60 (24.07%) years. Maximum number of seropositive cases for both HCV and HBV were from General surgery department as 63.23% &amp; 53.09% respectively. Conclusion: The study estimated high prevalence of HBV and HCV on routine screening of patients reporting to various surgical departments. Healthcare providers have significantly high risk of infectivity along with further transmission of the disease if pre-operative screening and standard precautions are not followed strictly

Dengue serology–role of NS1 antigen: evaluation and future prospect

Introduction: According to the estimates, nearly 70% of the disease burden occurs in Asia and is on constant rise. Dengue virus infection has emerged as a major public health concern across the globe in terms of mortality, morbidity and public health cost. Aims &amp; Objectives: This study was undertaken to evaluate the significance of NS1 Ag detection in dengue IgM negative sera as marker for early detection and to compare the rapid detection test kits (RDT’s) with Enzyme linked immunosorbent assay (ELISA). Material &amp; Method: A total of 5283 samples from, were screened for dengue serology by Immunochromatography based lateral flow assay for presence of IgM and IgG anti Dengue antibody and NS 1 Ag. Results of 169 samples were further confirmed using ELISA technique for NS1 Ag in an attempt to compare RDT’s with ELISA. Results: Out of 5283 samples screened, 146/5283 (2.76%) tested positive for dengue antibody, out of which 85/146(58.21%) were positive for DEN Ig M and 61/146(41.78%) showed presence of both IgG and IgM. Out of 5137 seronegative samples, 1930(37.57%) were positive for DEN NS1 Ag. Overall, sensitivity of RDT was 100.00%, specificity-90.16%, PPV- 94.73%, NPV-100.00 % and Efficiency of test -96.44%. Conclusion: NS1 Ag assay holds promise as useful tool in early diagnosis for detecting dengue infection during acute phase of infection when IgM antibodies are not formed to the detectable levels. Also, accurate and affordable diagnostic tests are a crucial component of combating this debilitating mosquito-borne infection