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Shastri, J.
- Seroprevalence of Human Immunodeficiency Virus Infection in Pregnancy in a Tertiary Care Hospital in Mumbai
Authors
1 T. N. Medical College & B.Y. L. Nair Charitable Hospital, Mumbai, IN
Source
The Indian Practitioner, Vol 67, No 12 (2014), Pagination: 766-768Abstract
Background - Estimating the seroprevalence of HIV in a low risk population such as pregnant women provides essential information for an effective implementation of AIDS control programmes and also for monitoring HIV spread within the country. HIV infection in women occurs primarily during their reproductive years, hence pregnancy provides a unique opportunity for implementing prevention strategies against HIV infection. If we estimate the seroprevalence in pregnancy, the effective and timely intervention will reduce the transmission of infection to newborns.
Aim - To study the seroprevalence of HIV infection in pregnancy in a tertiary care hospital.
Material and Methods - Blood samples of pregnant women with written informed consent were collected and tested for HIV antibodies as per National AIDS Control Organisation (NACO) guidelines over a period of three years from January 2007 to December 2009.
Results - Of the 8136 pregnant women tested in three years, 182 (2.24%) women were found to be HIV seroreactive (CI 1.92-2.56). Majority of the seroreactive pregnant women 41% were in the age group of 25-29 years followed by the 20-24 yrs (37%) and 30-34 years (14%) age group.
Conclusion - As prevalence of HIV infection in pregnant women is high and in the absence of protective vaccine, it is important to educate and create awareness among them about HIV infection in order to safe guard our future generation. Timely detection and effective counselling can prevent further pregnancies and consequent transmission of HIV infection to the offspring.
Keywords
Seroprevalence, HIV, Pregnant Women
- Incidence of Metallo Beta-Lactamases Producing Non-Fementers in a Tertiary Care Hospital
Authors
1 Department of Microbiology, TNMC & BYL Nair Hospital, Mumbai Central, ESIS Hospital, Mumbai-400008, IN
2 ESIS Hospital, Mumbai, IN
Source
The Indian Practitioner, Vol 67, No 4 (2014), Pagination: 219-223Abstract
Introduction: In recent years, resistance to carbapenems due to metallobetalactamse production is increasing. The genes (IMP and VIM) responsible for metallo beta-lactamase (MBL) production may be chromosomally or plasmid mediated and hence poses a threat of spread of resistance by gene transfer among the Gram-negative bacteria. Therefore early identification and treatment of infections with MBL producers becomes essential.
Screening of MBL is not done as routine in our laboratory. The present study was therefore undertaken to know the incidence of MBL producing bacteria in our set up.
Aims: To study incidence of metallo-beta-lactamase (MBL) producers among nonfermenters.
Material and Methods: 315 P. aeruginosa and 170 Acinetobacter species were isolated from blood and pus samples and evaluated for carbapenem resistance and MBL production by imipenem-EDTA disc method. The inhibition zone with imipenem-EDTA disc were <14 mm for MBL-negative isolates and >17 mm for MBL-positive isolates. MBL production was confirmed by E test strip containing imipenem (4- 256 μg/ml) and imipenem(1-64 μg/ml) plus EDTA.100/10 μg).
Results: Of 315 isolates of P. aeruginosa and170 isolates of Acinetobacter, of the total 315 P. aeruginosa 265 were isolated from pus and 50 from blood cultures and out of the total 170 of Acinetobacter spp120 from pus and 50 from blood cultures were isolated. Piperacillin/tazobactam and Imipenem were the most effective antibiotics for NFGNB.
Out of the 50 Imipenem resistant isolates tested, 9 (18%) were found to be MBL producers.
Conclusions: Identification of MBL production is mandatory for making appropriate choice of antibiotics. This enables to relook into the antibiotic policy, create awareness and strengthen infection control to prevent the further spread of MBL producers.
Keywords
MBL, Imipenem-EDTA, E Test.- Stenotrophomonas Maltophila Bacteraemia in a Chronic Renal Failure Patient
Authors
1 Department of Microbiology, 313 College building 3rd floor, T.N.M.C & BYL Nair Hospital, Mumbai-8, IN
2 Department of Microbiology, TNMC, Mumbai, IN
Source
The Indian Practitioner, Vol 67, No 3 (2014), Pagination: 173-175Abstract
The spectrum of infection by Stenotrophomonas maltophila includes bacteraemia, catheter-related infection, pneumonia, complicated biliary and urinary tract infection, and skin and skin-structure infection. We report a case of Stenotrophomonas maltophila bacteraemia in a case of a chronic renal failure patient who was receiving dialysis via a central venous catheter.Keywords
Stenotrophomonas Maltophila, Bacteremia.- Diagnosis of Malaria in Pregnancy: Field Situation and Use of Rapid Tests
Authors
1 Department of Obst & Gynaecology, T.N.M.C & BYL Nair Hospital, IN
2 Department of Microbiology, T.N.M.C & BYL Nair Hospital, IN
Source
The Indian Practitioner, Vol 67, No 1 (2014), Pagination: 23-27Abstract
Introduction: Malaria is endemic in India and constitutes a major public health challenge. Submicroscopic infection during pregnancy might be associated with increased risk of adverse pregnancy outcomes including low birth weight babies and maternal anaemia. Simple and easy to use malarial diagnostic tools with adequate sensitivity such as rapid diagnostic tests will help in accurate diagnosis and prompt treatment of pregnancy associated malaria and help in averting adverse pregnancy outcomes.
Aim: To assess testing methods available at a public hospital for diagnosis of malaria in pregnancy and discuss the use of appropriate test for diagnosis of malaria.
Material and methods: Data was analysed of pregnant women admitted in antenatal care (ANC ) ward with fever for period between January 2009 and December 2009 retrospectively with respect to demography of patients, slide positivity, Rapid malaria antigen test(RMAT) positive . Malaria PV/PF antigen card test by Accucare was used.
Results: Of the total ANC admissions 2880 in our hospital in the year 2009, 189 pregnant women were admitted with fever (6.5%) in our ANC ward. The standard protocol in our institute is to send peripheral smear (PS) for MP for all such cases and start presumptive therapy with chloroquine if symptoms suggestive of malaria. PS MP was positive in 28/189 i.e. 14.8%. Those who had persistent fever especially if PS for MP is negative were tested by RMAT (135 cases). Of those, 40 were positive 21.2 %.Utility and comparison of the tests will be discussed.
Conclusion: PS for MP is gold standard for diagnosis and gives additional information regarding type of parasite and density however it is requires expertise. RMAT is available, easy to perform and it is recommended that all RMAT are followed-up with microscopy to confirm the results and if positive, to quantify the proportion of red blood cells that are infected.
- Evaluation of Dengue Non Structural Antigen ELISA for the Diagnosis of Dengue Virus Infection in the Acute Phase of Illness
Authors
1 Department of Microbiology, T.N. Medical College & B.Y.L. Nair Charitable Hospital, Dr A L Nair Road, Mumbai Central, Opp. Maratha Mandir, Mumbai-400 008, IN
2 Department of Microbiology, T.N. Medical College & B.Y.L. Nair Charitable Hospital, Mumbai, IN
Source
The Indian Practitioner, Vol 68, No 3 (2015), Pagination: 29-33Abstract
Introduction: Dengue viruses are a major public health problem in tropical and subtropical areas, being the cause of one of the most important mosquito-borne viral diseases. Outbreaks have also been reported from Mumbai and other parts of Maharashtra.
Aims and Objectives: (1) Detection and evaluation of Non-Structural Protein (NS1 Ag) in the sera of suspected cases of dengue virus infection. (2) Evaluation of Rapid Immunochromatographic test and ELISA for detection of IgM/IgG antibodies.
Material and Methods: An open labeled prospective study was carried out using 150 patient's sera and 30 paired sera. The serum samples were subjected to Rapid Immunochromatographic test, ELISA and PCR tests.
Results: The sensitivity of Rapid test as compared to ELISA was 87.5% for IgM and 66.6% for IgG. Specificity for ELISA and Rapid test was 96.3% and 92.6% respectively. Sensitivity of NS1 Ag as compared to Dengue PCR was 86.66%.
Conclusion: Dengue NS1 Ag ELISA with its ability to specifically diagnose dengue in early stage of the disease with high sensitivity can prove a boon in the early treatment and management of dengue patients.
Keywords
Dengue, IgM ELISA, NS1 Ag ELISA.- Multidrug Resistant Extrapulmonary Tuberculosis at a Tertiary Care Centre
Authors
1 Topiwala National Medical College, Mumbai, IN
Source
The Indian Practitioner, Vol 69, No 2 (2016), Pagination: 37-39Abstract
Extrapulmonary manifestation of tuberculosis is prevalent in 10-34% of non HIV cases while it occurs in 50-70% of patients co-infected with HIV. Very limited data is available for drug resistance in extrapulmonary tuberculosis (EPTB). This was a prospective, observational study to assess the prevalence of multidrug resistant tuberculosis (MDRTB) from 90 clinically suspected cases of EPTB at a tertiary care centre in Mumbai. In the present study, M. tuberculosis was found in 18.88% of EPTB patients of which 47.05% were MDRTB. Maximum culture positivity (40%) was found in lymph node aspirates. High drug resistance to M. tuberculosis warrants periodic assessment of the trends of drug resistance to anti tuberculosis agents.- Trichosporon Beigelli Infection a Child with Congenital Extrophy Bladder
Authors
1 Department of Microbiology, BYL Nair Hospital, Mumbai-400008, IN