ABSTRACT
Leptospirosis is a zoonotic infection caused by the spirochaete Leptospira, which has worldwide distribution. Laboratory diagnosis is routinely performed by serological tests like dipstick assay, lateral flow assay and latex agglutination which are rapid tests recommended for screening the disease. Microscopic Agglutination Test (MAT) is the standard test for serological diagnosis of leptospiral infection which is not included in the test panel in most of the peripheral laboratories as the procedure is laborious and it requires to maintain live leptospira. Therefore, one of the rapid tests is routinely employed for demonstration of leptospiral antibodies. Our objective was to screen the acute cases of leptospirosis by Leptochek WB IgM and PanBio IgM Elisa and compare the findings with the MAT and correlate the clinical findings with the serological tests.METHODSThis study was conducted in a tertiary care hospital in Mangalore from August 2010 to September 2013. A total of 314 cases of clinically suspected leptospirosis were included based on the Faine’s criteria. Patients’ serum was screened for leptospiral antibodies by Leptochek WB IgM, PanBio IgM ELISA and Microscopic Agglutination Test (MAT).RESULTSOut of 314 clinically suspected cases screened, seropositivity for leptospirosis by Leptochek WB-IgM, PanBio IgM ELISA and MAT was found to be 49 (15.6%), 65 (20.7%) and 78 (24.8%) respectively. Thus, an overall prevalence rate of leptospirosis was 24.8% (78/314) based on the MAT test. Sensitivity, specificity, positive predictive value and negative predictive value of Leptocheck WB IgM was 53.8%, 97%, 85.7 and 86.4% with MAT while the comparative values of PanBio-ELISA IgM with respect to MAT test was 74.5%, 97 %, 89.2% and 92% respectively. Common clinical features among MAT positive cases were fever, chills and rigors, oliguria, vomiting, jaundice and headache.CONCLUSIONSMAT is a standard serological test for Leptospirosis. This test is not always available for peripheral health centres, as the test is time consuming and cumbersome. Thus, screening tests are now being employed for screening the patients. Rapid tests like Leptocheck -WB can be supplemented with an ELISA test for screening of clinically suspected cases of Leptospirosis and later confirmed with the MAT at reference centres.
ABSTRACT
Background: Many pathogenic fungi fluoresce in hematoxylin and eosin stained sections, and Papanicolaou (PAP)‑stained smears under ultraviolet illumination. In theory, this phenomenon could aid in the diagnosis of common fungal infections without the delay which is usually associated with special stains. Objective: To evaluate the role of fluorescence as a rapid screening technique for oral infections caused by Candida organisms in exfoliative smears of oral candidiasis. Materials and Methods: Two smears and one swab were collected from each of 62 clinically diagnosed cases of oral candidiasis. Smears were stained with (PAP) and periodic acid–Schiff stain (PAS). Both smears were evaluated under light microscopy (LM). Later, PAP smears were observed under fluorescent microscopy (PAP‑FM). The swab was inoculated on Sabouraud’s agar plate. Each technique was evaluated for sensitivity and specificity. Results: It was found that the PAS‑stained smears were more reliable for detection of Candida species than other methods (sensitivity = 100%; specificity = 66.7%). The PAP‑LM and PAP‑FM showed less sensitivity (67.9% and 85.7%) and specificity (66.7% and 33.3%), respectively. Combined results of both light and fluorescent microscopy of PAP (LM + FM) showed increased sensitivity (89.3%) but reduced specificity (16.7%). Conclusion: PAP autofluorescence is less sensitive than PAS, still it accentuates the distinct morphological features of Candida.
ABSTRACT
The bacterial strains that cause symptomatic urinary tract infections possess diverse distinctive properties that enable them to overcome the local host defences. In Escherichia coli, virulence results from the cumulative impact of several virulence factors, which can vary according to the patient populations. The study was undertaken to assess the prevalence of the virulence factors by phenotypic assays in the E. coli isolates which were isolated from patients with UTI from a tertiary care hospital in Kerala. Methods: A total of 300 E. coli isolates were obtained from symptomatic cases of urinary tract infections and 30 E. coli faecal isolates were obtained from apparently healthy individuals and they were tested for phenotypic properties like haemolysin production, mannose resistant hemagglutination to indicate P fimbriae, cell surface hydrophobicity. Results: Among the 300 E. coli isolates from the cases group, 135 (43.5%) were hemolytic, 106 (35.5%) were MRHA positive, 123 (41%) were hydrophobic. Among the 30 controls, 2 (6%) were hemolytic, 02 (6%) were MRHA positive and 04 (10%) were hydrophobic. The difference between the cases and the control group was significant (P <0.001). Multiple virulence factors were observed in 51% of the isolates. Conclusion: The present study showed varied phenotypic expression of the virulence factors in the urinary isolates as compared to the fecal isolates.
ABSTRACT
The study was conducted to know the prevalence of Pseudomonas aeruginosa in clinical infections and its antibiotic susceptibility pattern to commonly used antibiotics in a tertiary care teaching hospital. We received 897 relevant clinical isolates among, which 203 was P.aeruginosa. Antibiotic susceptibility was determined by Kirby Bauer’s disc diffusion method with first line and second line antibiotics. Results – Among the first line antibiotics the isolate displayed an increased resistance to Ciprofloxacin (28.57%) followed by Levofloxacin (25.61%), and the least was towards Amikacin (14.77%), whereas most of the second line antibiotics such as Polymyxin B and Colistin exhibited a high sensitivity (99.02 %.). Conclusion-The ability of the opportunistic pathogen P.aeruginosa to rapidly develop resistance to multiple classes of antibiotics during the course of treatment makes it important to determine the antibiotic susceptibility pattern. As the pipeline of new drugs continues to diminish, it is critical that we look for new strategies to combat the threat of antibacterial resistance.
ABSTRACT
BACKGROUND: Onychomycosis is a common problem noticed in clinical practice. Currently available standard laboratory methods show inconsistent sensitivity; hence there is a need for newer methods of detection. AIMS: This study involves comparison of standard laboratory tests in the diagnosis of onychomycosis, namely, potassium hydroxide mount (KOH mount) and mycological culture, with histopathologic examination using periodic acid-Schiff (PAS) staining of the nail clippings. METHODS: A total of 101 patients with clinically suspected onychomycosis were selected. Nail scrapings and clippings were subjected to KOH mount for direct microscopic examination, culture using Sabouraud's dextrose agar (with and without antibiotics) and histopathologic examination with PAS staining (HP/PAS). Statistical analysis was done by McNemar's test. RESULTS: Direct microscopy with KOH mount, mycological culture, and HP/PAS showed positive results in 54 (53%), 35 (35%), and 76 (75%) patients respectively. Laboratory evidence of fungal infection was obtained in 84 samples by at least one of these three methods. Using this as the denominator, HP/PAS had a sensitivity of 90%, which was significantly higher compared to that of KOH mount (64%) or mycological culture (42%). CONCLUSIONS: Histopathologic diagnosis with PAS staining of nail clippings was the most sensitive among the tests. It was easy to perform, rapid, and gave significantly higher rates of detection of onychomycosis compared to the standard methods, namely KOH mount and mycological culture.