Surveillance of drug-resistant tuberculosis in the state of Gujarat, India

BACKGROUND: Limited information about the prevalence of drug-resistant tuberculosis (TB) has been reported from India, the country with the world’s highest burden of TB. We conducted a representative state-wide survey in the state of Gujarat (2005 population: 56 million). METHODS: Mycobacterium tuberculosis isolates from a representative sample of new and previously treated smear-positive pulmonary TB (PTB) cases were subjected to drug susceptibility testing (DST) against fi rst-line drugs at a World Health Organization supranational reference laboratory. Isolates found to have at least both isoniazid (INH) and rifampicin (RMP) resistance (i.e., multidrugresistant TB [MDR-TB]) were subjected to second-line DST. RESULTS: Of 1571 isolates from new patients, 1236 (78.7%) were susceptible to all fi rst-line drugs, 173 (11%) had any INH resistance and MDR-TB was found in 37 (2.4%, 95%CI 1.6–3.1). Of 1047 isolates from previously treated patients, 564 (54%) were susceptible to all fi rst-line drugs, 387 (37%) had any INH resistance and MDR-TB was found in 182 (17.4%, 95%CI 15.0–19.7%). Among 216 MDR-TB isolates, 52 (24%) were ofl oxacin (OFX) resistant; seven cases of extensively drug-resistant TB (XDR-TB) were found, all of whom were previously treated cases. CONCLUSION: MDR-TB prevalence remains low among new TB patients in Gujarat, but is more common among previously treated patients. Among MDR-TB isolates, the alarmingly high prevalence of OFX resistance may threaten the success of the expanding efforts to treat and control MDR-TB

Isolation and partial purification of erythromycin from alkaliphilic Streptomyces werraensis isolated from Rajkot, India

AbstractAn alkaliphilic actinomycete, BCI-1, was isolated from soil samples collected from Saurashtra University campus, Gujarat. Isolated strain was identified as Streptomyces werraensis based on morphological, biochemical and phylogenetic analysis. Maximum antibiotic production was obtained in media containing sucrose 2%, Yeast extract 1.5%, and NaCl 2.5% at pH 9.0 for 7 days at 30 °C. Maximum inhibitory compound was produced at pH 9 and at 30 °C. FTIR revealed imine, amine, alkane (CC) of aromatic ring and p-di substituted benzene, whereas HPLC analysis of partially purified compound and library search confirmed 95% peaks matches with erythromycin. Chloroform extracted isolated compound showed MIC values 1 μg/ml against Bacillus subtilis, ≤0.5 μg/ml against Staphylococcus aureus, ≤0.5 μg/ml against Escherichia coli and 2.0 μg/ml against Serretia GSD2 sp., which is more effective in comparison to ehtylacetate and methanol extracted compounds. The study holds significance as only few alkaliphilic actinomycetes have been explored for their antimicrobial potential

Detubularized isolated ureterosigmoidostomy in a complicated common cloaca: A case report

Urinary incontinence in a child secondary to a severe congenital anatomical disorder or due to complication of a previous surgery can be difficult to manage. Decisions can be especially hard when a redo procedure is being considered. We present one such case where a 6 year old girl previously operated for cloaca was brought with incontinence and after much consideration of options available, underwent a modified ureterosigmoidostomy to aid in her continence. The modification used was detubularized isolated ureterosigmoidostomy, described by Atta et al in 1996