A cross‑sectional study on aetiology of diarrhoeal disease, India.

Background: Global, regional and national estimates clearly place diarrhoeal diseases as a major, albeit to an extant neglected public health problem. Deaths of children aged <5 years owing to diarrhoea was estimated to be 1.87 million at the global level (uncertainty range from 1.56 to 2.19 million), which is approximately 19% of total child deaths. Objectives: The present report is a cross‑sectional study undertaken to estimate the role of various aetiological agents causing diarrhoea in North Karnataka and adjoining areas of Maharashtra and Goa. Methods: Three hundred stool samples were collected from patients seeking health care at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum; and processed for detection of various bacterial, viral and parasitic agents. Results: Bacterial pathogens attributed to 65.7% of diarrhoea cases, followed by viral infection (22%), parasitic infection (16.3%) and infection by Candida spp. (5.6%). The study identified Escherichia coli in general and Enteropathogenic E. coli in particular, and Group A Rotavirus to be the most frequently isolated pathogens among diarrhoea patients. Conclusion: The data generated from the current study will help the health officials for better interventional and treatment strategies for diarrhoeal diseases.

Clinical significance of various diagnostic techniques and emerging antimicrobial resistance pattern of Helicobacter Pylori from Gastric Biopsy Samples.

Background: There is no single technique that can meet the criteria in identification of Helicobacter pylori. The diagnosis is important asantimicrobial resistance is frequently observed and associated with treatment failure. The present study was conducted to evaluate diagnostic tests for identification of H pylori and to assess their antimicrobial resistance pattern. Materials and Methods: Biopsies of gastric tissue from 200 patients with disorders of the upper gastrointestinal tract were studied for detection of H pylori by various methods like culture, H and E staining and urease test. Antimicrobial susceptibility testing was carried out by Kirby Bauer’s disc diffusion method. Results: Out of 200 patients, H pylori was detected by rapid urease test, H and E staining and culture in 26.5%, 14.5% and 2.5% cases respectively. H and E was taken as the gold standard. Sensitivity of urease test was 76.6% and of culture 13.3%. Specificity of urease was 81.7% in comparison with culture which showed 99.4% specificity. Metronidazole (05) showed high level of resistance followed by amoxicillin (03) and norfloxacillin (03). Tetracycline, erythromycin, levofloxacin and cotrimoxazole showed one resistance each to H pylori. Conclusion: H and E is taken as the gold standard according to CDC. Urease test is a better screening procedure than culture. H pylori resistance to metronidazole in our zone was highest. This is due to general and extensive use of metronidazole for other infectious diseases. Our study suggests need for a systematic approach to determine antibiogram of the strains before considering the drug regimens.

Primary cutaneous actinomycosis: a rare soft tissue infection.

Actinomycosis caused by Actinomyces spp. is a chronic and suppurative infection caused by an endogenous gram positive bacterium. The unusual sites of infection are the head and neck, thorax and abdomen and are almost always endogenous in origin. Primary cutaneous actinomycosis is very rare and is usually associated with external trauma and local ischemia. We report a case of a primary cutaneous actinomycosis of the thigh in a 30-year-old man. The patient acquired the infection through an injection wound which progressed to multiple discharging sinuses. Clinical material from the wound demonstrated the presence of Actinomyces in smears and cultures. The patient was diagnosed and successfully treated with surgical resection and combined antibiotic therapy.

Haemagglutination and siderophore production as the urovirulence markers of uropathogenic Escherichia coli.

A total of 160 strains of Escherichia coli isolated from urine of patients with clinically diagnosed urinary tract infection were included in the study and 50 faecal isolates of E. coli were studied. They were studied for virulence factors, namely mannose-resistant and mannose-sensitive haemagglutination (MRHA, MSHA) and siderophore production.Among 160 urinary isolates of E. coli , 40 (25%) showed MRHA, siderophore production was seen in 156 (97.5%). In 50 faecal isolates, two (4%) were MRHA, four (8%) MSHA and siderophore production in two (4%). The results suggest that MRHA and siderophore production positive strains can be considered as UPEC.

Cutaneous actinomycosis: a rare case.

Cutaneous actinomycosis is a rare presentation. Here we present a case of cutaneous actinomycosis with no history of trauma or systemic dissemination. The isolate was identified as Actinomyces viscosus by standard methods. The isolate was found to be penicillin resistant by Kirby Bauer disc diffusion method. Therefore, the patient was treated with cotrimoxazole and improved. Thus, this case highlights the importance of isolation and susceptibility testing in actinomycotic infection. The sinuses have healed, and the patient has recovered.

Lepromatous leprosy of histoid type.

Histoid leprosy is a variant of lepromatous leprosy, which develops as a result of resistance to dapsone monotherapy. Here we report two cases of lepromatous leprosy of histoid type, one with typical and another with atypical presentations.

Infective endocarditis due to brucella.

One of the complications of brucellosis is infective endocarditis, which carries a high mortality rate if undiagnosed or misdiagnosed. We report a case of Brucella infective endocarditis, which was diagnosed serologically and by polymerase chain reaction. After Brucella specific treatment, patient showed dramatic improvement clinically, as evident by echocardiogram findings and other investigations.