Pleuropulmonary nocardiosis due to Nocardia otitidiscaviarum in a debilitated host.

Nocardia otitidiscaviarum is a rare cause of pulmonary nocardiosis. We present a case of pulmonary nocardiosis with pleural involvement in an adolescent with rheumatic heart disease and congestive cardiac failure presenting with right lower lobe consolidation and pleural effusion. Direct gram‑stain of pleural fluid showed pus cells with Gram‑positive filamentous branching bacilli. Empiric treatment with parenteral ceftriaxone and supportive therapy for cardiac failure was initiated. Pleural fluid culture yielded growth of N. otitidiscaviarum at 72 h. Antibiotic susceptibility testing showed resistance to cephalosporins. The patient expired due to congestive cardiac failure on the 5th day.

On the path of continual improvement: An evaluation of biomedical waste management training.

Microbiologists play a pivotal role in the prevention of infection both at hospital and community level. Biomedical waste management (BMWM) is one of the aspects of infection control. For the effective implementation of this, various training programmes have been conducted at our regional training centre. This study evaluates the impact of the BMWM training programme. Knowledge on all parameters was signifi cantly better at post-course evaluation for all the participants (P value 0.001). Evaluation of training is recommended to improve the effectiveness of training method.

An analysis of multimodal occupational exposure leading to blood borne infections among health care workers.

Occupational exposure poses a signifi cant risk of transmission of blood-borne pathogens to healthcare workers (HCWs). Adherence to standard precautions, awareness about post exposure prophylaxis is poor in developing countries. This retrospective study analyzes the self-reported cases of occupational exposure in a tertiary care hospital. During the study period, 105 HCWs sustained occupational exposure to blood and body fl uids. Majority of the victims 36 (34.2%) were interns and the clinical practice that led to the occupational exposure was withdrawal of blood (45.7%). Good infection control practices and emphasis on appropriate disposal are needed to increase the occupational safety for HCWs.

Myroides odoratus and Chryseobacterium indologenes: Two rare isolates in the immunocompromised.

Myroides spp and Chryseobacterium spp are uncommon clinical isolates, though more frequently reported to cause infections than other pigmented non‑fermentors. Two cases of Myroides odoratus and Chryseobacterium indologenes infection in a diabetic with pulmonary tuberculosis and a patient with de‑compensated alcoholic liver disease, respectively, are reported here. Anti‑microbial susceptibility testing of the isolates was performed by determining the minimum inhibitory concentration. The clinical picture, characteristic features of the isolates and the antibiotic susceptibility pattern are discussed briefly.

Complement-dependent lymphocytotoxicity crossmatch in deceased donor renal transplant: A single institutional experience.

Complement-dependent lymphocytotoxicity crossmatches (n=217) between 47 deceased donors and 150 potential renal recipients were retrospectively studied. A negative cross match was reported in 48 (22.1%), doubtful positive in 126 (58.1%), weakly positive in 32 (14.7%) and positive in 11 (5.1%). No autoantibodies were detected. Renal transplantation was performed in 35.5% of the potential recipients. There was no incidence of hyperacute rejection. The graft survival rate was 88% at 15 months of follow up. The study concludes that a negative pretransplant lympocytotoxicity crossmatch using the basic National Institute of Health technique eliminates hyperacute rejection, but carries drawbacks, which require modification and supplementation with more sensitive and specific assays.

Subcutaneous phaeohyphomycosis due to Exophiala spinifera in an immunocompromised host.

A case of phaeohyphomycosis presenting as multiple subcutaneous abscesses in a young lady with deteriorating liver function was reported here. The lesion started as a solitary abscess in the neck, mimicking tuberculous cold abscess and rapidly involved the face, chest, arms, and legs within six months with ulceration and discharge of thick brownish foul smelling pus. Potassium hydroxide mount of pus from various sites revealed septate dematiaceous hyphae and pseudohyphae. Culture yielded pure growth of Exophiala spinifera. Tissue debridement was done along with initiation of antifungal therapy with ketoconazole. As liver function deteriorated, antifungal therapy was withdrawn after seven days. Patient expired three weeks after admission due to hepatic failure.