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July-September 2015
Volume 7 | Issue 3
Page Nos. 95-124
Online since Tuesday, August 18, 2015
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EDITORIAL
State of the globe: Toxin and toxic genes associated with
Staphylococcus aureus
and clinical implication
p. 95
Avinash Agrawal
DOI
:10.4103/0974-777X.163076
PMID
:26392715
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ORIGINAL ARTICLES
Prevalence of toxin genes among the clinical isolates of
Staphylococcus aureus
and its clinical impact
p. 97
Divya Deodhar, George Varghese, Veeraraghavan Balaji, James John, Grace Rebekah, Jeshina Janardhanan, Ranjith Jeyaraman, Sudha Jasmine, Prasad Mathews
DOI
:10.4103/0974-777X.162234
PMID
:26392716
Introduction:
Staphylococcus aureus
(
S. aureus
) causes a variety of infections, ranging from a mild skin infection to blood stream infections and deep seated infections. As
Stapylococcus aureus
bacteremia (SAB) has the tendency to cause endovascular and metastatic infections, complications can occur at almost all sites of the body. Hence, SAB is associated with increased morbidity and mortality in spite of appropriate antimicrobial treatment. The virulence in
S. aureus
is determined by the presence of adhesins and toxins, which behave like superantigens (SAgs) and leads to a massive release of proinflammatory cytokines causing overwhelming inflammatory response leading to endothelial leakage, hemodynamic shock, multiorgan failure, and possibly death.
Materials and Methods:
One year prospective study conducted in a tertiary care hospital in southern part of India included all patients with SAB. Clinical details were filled according to. All isolates were subjected to polymerase chain reaction (PCR) for enterotoxin profiling.
Results:
A total of 101 patients of SAB were identified which comprises of 61 (60.4%) patients with methicillin-susceptible
S. aureus
(MSSA) and 40 (39.6%) patients with methicillin-resistant
S. aureus
(MRSA). Most common predictors of mortality were prior hospitalization and antibiotic intake, severe organ dysfunction, shock, tachycardia, and leukocytosis. Two-third of the isolates had at least one enterotoxin, most prevalent was
sea
; 28% and 27% (
P
- value = 0.001) MSSA isolates had
seg
and
sei
; whereas, 38.6% (
P
- value < 0.001) of MRSA isolates were found to have
sea
. The most common enterotoxin associated with mortality was
sei
, which comprised of 38% of all mortality.
Conclusion:
In SAB, the significant predictors of mortality were prior hospitalization and antibiotic intake, presence of multiorgan dysfunction, and shock. Although overall significance between the enterotoxin and shock could not be demonstrated, it successfully demonstrated the difference of enterotoxin between MSSA and MRSA.
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Knowledge and attitudes about HIV/AIDS in illegal residents in the Kingdom of Saudi Arabia
p. 103
Ziad A Memish, Sanaa M Filemban, Sabirah N Kasule, Jaffar A Al-Tawfiq
DOI
:10.4103/0974-777X.161744
PMID
:26392717
Objectives:
To study the knowledge, attitudes, and practices with regard to human immunodeficiency virus infection / acquired immune deficiency syndrome (HIV/AIDS) in illegal residents, in the Kingdom of Saudi Arabia (KSA).
Materials and Methods:
A questionnaire study was conducted among the illegal residents from four regions in Saudi Arabia: Jeddah, Makkah, Riyadh, and Jazan.
Results:
The survey enrolled 5,000 participants, 79%male (39.6% from Jeddah; 20% from Riyadh; and 20% from Jazan), aged between 15 and 45 years. Of the total, 1288 (25.8%) had not heard about HIV/AIDS. Knowledge of HIV transmission was poor in 90% of the respondents. Of the total, 737 had read about HIV/AIDS materials and 649 participants had been previously tested for HIV. The majority of participants (85%) held a negative attitude toward people living with HIV/AIDS. Those who were knowledgeable about HIV/AIDS expressed more a positive attitude. One-fifth (968, majority were men; single 55%, married 45%) had engaged in non-marital sexual activity. The largest proportion of the individuals who had engaged in non-marital sex were single (54.9%) followed by the married ones (40.4%). Men cited pleasure as the main reason for such activity (84.6%), whereas women (73.4%) cited financial gain. Of the respondents, 53.9 and 32.1% believed that TV and schools were the best media through which information with regard to HIV/AIDS could be imparted.
Conclusions:
Knowledge of HIV/AIDS, its mode of transmission, and prevention measures was poor. Educational programs specifically targeted toward this group were required.
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Diagnostic utility of QuantiFERON-TB gold (QFT-G) in active pulmonary tuberculosis
p. 108
Ahmed Anwar, AL-Jahdali Hamdan, Baharoon Salim, Ali Yosra, Mohamed Hani, AL-Harbi Abdullah
DOI
:10.4103/0974-777X.162231
PMID
:26392718
Background:
The utility of QuantiFERON-TB Gold In-Tube (QFT-G) test in the diagnosis of tuberculosis disease has been validated in high and low tuberculosis-prevalent (TB) countries. Aim: The aim of this study is to assess the performance of the QFT-G test in the diagnosis of tuberculosis disease among tuberculosis patients in an intermediate prevalent country.
Setting and Design:
A retrospective study at the King Abdulaziz Medical City-Riyadh (KAMC-R)
Materials and Methods:
We retrospectively reviewed all the patients with a diagnosis of pneumonia, including tuberculosis, admitted to KAMC-R between 1 January 2009 and 31 December 2013. We included only patients with an available result of the QFT-G test. A total of 142 tuberculosis cases and 226 pneumonia cases were studied, to assess the utility of the QFT-G test in diagnosing tuberculosis cases.
Results:
Among the tuberculosis (n = 142) cases, the QFT-G tested positive in 68.3%, negative in 23.2%, and indeterminate in 12 cases (8.5%). Of the 226 pneumonia cases, the QFT-G tested positive in only 20.4%, while a majority of 66.4% tested negative, with 30 cases (13.3%) being indeterminate. When we excluded 42 patients with indeterminate results, the QFT-G test achieved a sensitivity of 74.6% [95% CI: 66.09 to 81.65%] and specificity of 76.53 % [95% CI: 69.85 to 82.15%] in the diagnosis of tuberculosis cases.
Conclusions:
This study concludes that the QFT-G test is a useful tool for detecting tuberculosis disease when used as an adjunct tool for the diagnosis of active TB cases. It certainly cannot be used solely and indiscriminately, separate from other clinical and radiological information, in the diagnosis of active tuberculosis cases.
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MICROBIOLOGY REPORTS
Antibiotic resistance pattern of uropathogens: An experience from north Indian cancer patient
p. 113
Nishat Hussain Ahmed, Kausalya Raghuraman, Frincy Khandelwal Baruah, Rajesh K Grover
DOI
:10.4103/0974-777X.161742
PMID
:26392719
Empirical treatment of urinary tract infections (UTIs) can be made evidence based if it is governed by the resistance pattern of common uropathogens. A retrospective study was carried out at a tertiary care cancer institute to identify the common uropathogens and to know their resistance profile. 20.82% of the outpatients' urine samples (community-acquired urinary tract infection (CA-UTI)) and 24.83% of the indoor patients' urine samples (hospital-acquired urinary tract infection (HA-UTI)) grew uropathogens.
Escherichia coli
was the predominant pathogen both in CA-UTI (68%) and HA-UTI (45%) followed by
Klebsiella spp
and
Enterococcus spp
. High level of resistance to fluoroquinolones and third generation cephalosporins was noted. Nitrofurantoin was found to be a reliable oral drug for treatment of most of the uropathogens.
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CASE REPORT
Does the influenza vaccine prevent sequelae such as myocarditis from developing?
p. 116
Ryan Whitney, Jason Dazley, Ryan Gilbert, Jihad Slim
DOI
:10.4103/0974-777X.163102
PMID
:26392720
Vaccination continues to be a valuable and simple procedure to guard patients from an illness that may prevent them from completing their normal everyday tasks, missing days of work, and even lead to unnecessary sequelae. The following case describes one of the many complications that are seen on a regular basis in any community hospital in different regions of the world. The objective of this publication is to remind the public and practitioner of the urgency to vaccinate each season; thereby, curbing the virus's ability to mutate and preventing unwanted consequences such as bacterial super infection or myocarditis.
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LETTERS TO EDITOR
A red flag for community-acquired pneumonia in the elderly
p. 119
Tanmay S Panchabhai, Debabrata Bandyopadhyay, Valeria Arrossi, Kyle D Brizendine, Muzaffar Ahmad
DOI
:10.4103/0974-777X.146383
PMID
:26392721
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The role of procalcitonin levels in assessing the severity of
Clostridium difficile
infection
p. 120
Jason Dazley, Hamid Shaaban, Shoaib Afridi, Jihad Slim
DOI
:10.4103/0974-777X.162229
PMID
:26392722
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Retrobulbar optic nerve cysticercosis
p. 122
Ramakrishna Narra, J Naga Narasimharaju Jukuri, Sushil Kumar Kamaraju
DOI
:10.4103/0974-777X.161743
PMID
:26392723
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Cryptococcal meningitis with multiple cranial nerves palsies: A review of literature
p. 123
Adhiti Krishnamoorthy, Anjana Joel, Kundavaram Paul Prabhakar Abhilash
DOI
:10.4103/0974-777X.161739
PMID
:26392724
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© 2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer -
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Online since 10
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December, 2008