Emerging incidence of candidemia in neonatal intensive care unit and sick newborn care unit in a tertiary care hospital of Eastern India

Background: Candida blood stream infection (BSI) is an important cause of sepsis and sepsis-related mortality. Common risk factors for Candida BSI include very low birth weight, central vascular catheterization (CVC), use of broad-spectrum antibiotics, endotracheal intubation, and prolonged hospital stay. Although C. albicans accounts for Candida BSI among infants, but recent studies have detected a shift towards non-albicans Candida (NAC) species. Aims & Objectives: To isolate and identify different species of candida from blood samples. To find out the antifungal sensitivity pattern of the fungus isolated. To identify various risk factors associated with Candidemia in patient admitted in critical care unit. Methods: BACT/ALERT 3D Paediatric bottle was used for fungal blood culture. Inoculation on Blood agar and Sabourads dextrose agar (SDA) was made from the culture positive bottles. After the growth obtained from SDA, Gram staining, Germ tube test, CHROM agar Candida Medium and Sugar fermentation and biochemical Test kits (KB006 Hi Candida Identification Kit) were used for identification of various Candida Spp. Anti fungal susceptibility test was carried out by Kirby-Bauer disc diffusion method. Results: Out of 84 different species of Candida, C. albicans were the highest number (32.14%), followed by 23.81% of C. tropicalis, 21.42% C. parapsilosis. Susceptibility for voriconazole, fluconazole and amphotericin B was 85.71%, 75% and 64.28%, respectively. NAC (57 isolates) were more resistant to azole group of antifungal, especially commonly used antifungal like fluconazole (45.6%). Conclusion: Candidemia is a significant problem in Pediatrics age group patients, especially in NICU and SNCU. A gradual but significant epidemiological shift to higher isolation of NCA is being noticed

Altered resistin and IL6 in Neonatal sepsis in patients admitted in a tertiary care teaching hospital at Eastern India

Background: Neonatal sepsis is a clinical syndrome followed by bacteraemia in the first month of life and appears to be one of the primary causes of mortality and morbidity worldwide. The study aim was to detect the levels of resistin, IL-6, CRP and hs-CRP in clinically suspected cases of neonatal sepsis and establish its association with the pathogenesis of the disease. Materials & Methods: The case control study consists of 78 neonates of whom 42 were clinically suspected case of sepsis admitted in NICU of Paediatric department and were taken as cases and 36 were normal healthy neonates taken as control subjects in a tertiary care teaching hospital, Durgapur, West Bengal. The cases as well as controls were within 28 days of age. Preterm and term neonates (< 28 days of age) of both sexes showing signs of both early and late onset sepsis and also blood culture positive were included in the study. Two ml of blood was collected without anticoagulant and serum was separated by centrifugation at 3500 rpm for 15-20 mins and was used for measurement of hs-CRP, resistin and IL 6. Serum hs-CRP levels was determined with a high-sensitivity nephelometric method while the serum level of IL-6 and Resistin were measured by immunoassay Kits (Raybiotech, USA). Results: Serum resistin levels were increased in sepsis cases as compared to controls and were statistically significant (38.96 ± 17.15 vs 15.49 ± 8.54 ng/ml; p < 0.0001). It was also observed that serum IL 6 levels were higher in sepsis cases as compared to controls which was statistically significant (58.19 ± 39.97 versus 8.48 ± 3.90 pg/ml; P < 0.0001). However, a weak positive correlation was observed between serum resistin with serum IL 6 level (r = 0.343; P = 0.025) among neonatal sepsis subjects while no correlation was seen in controls (r = 0.141; P = 0.411). Conclusion: The measurement of these sepsis markers is extremely important only in case of neonates with unclear infectious status. We have observed a significant rise in Resistin or IL 6 or hs-CRP which may be suggested as specific marker for the identification of neonatal sepsis.  The combination of Resistin or IL 6 or CRP or hs-CRP could therefore be crucial for the diagnosis and would be better predictors of neonatal sepsis and may be crucial in the pathogenesis of the disease. Keywords: Preterm neonates, neonatal sepsis, mortality and morbidity, serum resistin, interleukin-6 (IL-6), hs-CR

ORAL ITRACONAZOLE FOR THE TREATMENT OF SEVERE SEBORRHOEIC DERMATITIS

Background : Seborrheic dermatitis (SD) is an inflammatory skin disorder in which colonies of Malassezia furfur have been found in affected areas. Aim: The aim of this study was to evaluate the efficacy of itraconazole in the treatment of severe SD. Materials and Methods: Itraconazole was given to 30 patients of SD in a dose of 100 mg twice daily for 1 week followed by 200 mg/day for first 2 days of the following 2 months. The response was noted on day 15, 30, 60, and 90. The clinical response was graded as markedly effective, effective, or ineffective. Results: Clinical improvement (evaluated as markedly effective or effective) was observed in 83.3% cases. Conclusion : The anti-inflammatory activity of oral itraconazole suggests that it should be the first-line therapy in severe SD

Bacteriological study of aerobic isolates from plantar ulcers of paucibacillary leprosy patients

Background: Plantar ulcers commonly occur in leprosy patients, which usually recur and cause morbidity in such cases. Aims: The aim of the study is to find out the bacteriological profile of these ulcers and to find out the antibiotic susceptibility of the isolates so that appropriate drugs may be chosen for treatment and for prevention of recurrence. Materials and Methods: Fifty-six samples from recurrent plantar ulcers of paucibacillary leprosy patients (attending the outpatient department of Calcutta School of Tropical Medicine) were studied for the purpose. Proper sample collection, gram staining, inoculation on culture media, and final identification by biochemical methods were undertaken. Antibiotic susceptibility testing was done for appropriate choice of drugs. Results: Mixed growth of bacteria was seen in 20 (36%) cases while single organism was isolated from the rest. Staphylococcus aureus is the predominant single isolate followed by E. coil, Proteus sp. and Pseudomonas sp. Chloramphenicol and gentamycin are the two drugs that have shown efficacy to the extent of 75 to 100% and 25 to 100% respectively in vitro studies. Conclusion: Bacteriological study of plantar ulcers of leprosy patients has revealed Staphylococcus aureus as the main pathogen. Treatment with chloramphenicol and gentamycin holds good prospect as per our study

Protective Role of Black Tea Extract against Nonalcoholic Steatohepatitis-Induced Skeletal Dysfunction

Aim. This paper aimed to examine the chemoprotective actions of aqueous black tea extract (BTE) against nonalcoholic steatohepatitis- (NASH-) induced skeletal changes in rats. Material. Wistar rats (body wt. 155–175 g) of both sexes, aged 4–5 months, were randomly assigned to 3 groups; Group A (control), Group B (60% high-fat diet; HFD), and Group C (HFD + 2.5% BTE). Methods. Several urinary (calcium, phosphate, creatinine, and calcium-to-creatinine ratio) serum (alkaline phosphatase and serum tartrate-resistant acid phosphatase), and molecular markers of bone turnover (receptor activator of NF-κB ligand (RANKL), osteoprotegerin (OPG), and estrogen) were tested. Also, several bone parameters (bone density, bone tensile strength, bone mineral content, and bone histology) and calcium homeostasis were checked. Results. Results indicated that HFD-induced alterations in urinary, serum, and bone parameters as well as calcium homeostasis, all could be significantly ameliorated by BTE supplementation. Conclusion. Results suggest a potential role of BTE as a protective agent against NASH-induced changes in bone metabolism in rats

Genomic Characterization of Nipah Virus, West Bengal, India

An intrafamilial outbreak in West Bengal, India, involving 5 deaths and person-to-person transmission was attributed to Nipah virus. Full-genome sequence of Nipah virus (18,252 nt) amplified from lung tissue showed 99.2% nt and 99.8% aa identity with the Bangladesh-2004 isolate, suggesting a common source of the virus