Unimicrobial appendicitis due to non-vaccine serotype of streptococcus pneumoniae: Implications for and management and prevention.

The aetiology of appendicitis is usually polymicrobial. We report a rare case of appendicitis caused by Streptococcus pneumoniae as the only causative organism. The case assumes significance because it occurs in the absence of any predisposing factor for invasive pneumococcal infection, it is unimicrobial, it may lead to the misdiagnosis of primary peritonitis due to pneumococcus, and it undermines the efficacy of polyvalent pneumococcal vaccine.

Throat carriage of pneumococci in healthy school children in the Union Territory of Pondicherry.

BACKGROUND & OBJECTIVES: Colonisation of Streptococcus pneumoniae in the throat is common among children the world over. Little is known about the relationship of nasopharyngeal carriage and invasive disease or the way it spreads within the households and close confines. There is a paucity of data on the colonization of Strep. pneumoniae in the throat of healthy children in India. To determine the prevalence of pneumococcal carriage in school children of urban and rural Pondicherry, a study was undertaken. METHODS: Throat swabs of healthy school-going children between 5-10 yr of age were examined for pneumococcal carriage, by standard bacteriological techniques. RESULTS: A prevalence rate of 24.3 per cent was noted. There was no difference in the carriage rate among the rural children when compared to urban children. No age, sex or geographical predilection of pneumococcal carriage was noted. A statistically significant seasonal variation, however, was seen. Carriage rate increased during the colder months and was found to be the highest in the months of March and November. INTERPRETATION & CONCLUSIONS: Strep. pneumoniae circulates in the community among healthy children. Carriage rate is influenced by seasonal variation.

Bacterial contamination of anterior chamber during IOL surgery.

PURPOSE: To study the nature and frequency of bacterial contamination during cataract surgery. METHODS: The preoperative smears from the conjunctiva and anterior chamber (AC) fluid aspirates during extra-capsular cataract surgery (ECCE) with posterior chamber intraocular lens (PCIOL) implantation in 40 eyes were analysed for aerobic and anaerobic bacteria. Any change in the bacterial strains isolated before and after cataract surgery was also studied. RESULTS: AC fluid aspirates were positive for bacteria in 15 eyes (37.5%). Coagulase-negative Staphylococcus was the most common aerobe (39.4%) and Propionibacterium acnes the most common anaerobe. Of the 15 cases with positive AC fluid cultures, 6 showed an organism in the AC aspirate different from the conjunctival smear. CONCLUSION: Clinically there was no endophthalmitis in any of the eyes. Factors such as preoperative antibiotic use, the antibacterial properties of aqueous, or low inoculum size could explain this. The preoperative conjunctival smear may not be useful in predicting the AC fluid contamination or outcome of cataract surgery.