Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) for the proteomic based identification of Aggregatibacter actinomycetemcomitans isolated from orodental infections.

Aim: Aggregatibacter actinomycetemcomitans is a fastidious gram negative cocco bacilli responsible for aggressive and chronic periodontitis as well as other systemic infections. In this study the usefulness of MALDITOF MS a proteomic based study was evaluated for the identification of A. actinomycetemcomitans isolates from orodental infections. Materials and methods: Fifty clinical isolates of A. actinomycetemcomitans obtained from orodental infections were subjected for identification with conventional as well as MALDITOF MS analysis. Results: All the isolates tested were accurately identified by the MALDITOF MS analysis. Among the 50 isolates 35 were identified at secure and probable species level and another 15 were identified at highly probable species level. Conclusion: MALDITOF MS is reliable, cost effective and rapid test for the identification of slow growing fastidious bacteria like A. actinomycetemcomitans compared with conventional methods

A sporadic outbreak of Burkholderia cepacia complex bacteremia in pediatric intensive care unit of a tertiary care hospital in coastal Karnataka, South India.

Burkholderia cepacia complex (BCC) is a significant opportunistic pathogen in hospitalized and immunocompromised patients, particularly in cystic fibrosis. It is widely distributed in natural habitats such as soil and water and frequently encountered in nosocomial outbreaks due to contaminated disinfectants and medical devices. However reports on outbreaks due to this organism are lacking from the Indian subcontinent. We report here a sporadic outbreak due to BCC which occurred in the pediatric Intensive Care Unit of our institute, the probable source being contaminated distilled water. The isolate from three babies and environmental sources including distilled water were identical and confirmed as BCC. Strict infection control measures were instituted to prevent the spread of infection. This report highlights the potential role of B.cepacia in causing sporadic outbreaks especially in ICUs, associated with water.

Antibacterial Activity of Essential Oil of Cymbopogon Flexuosus (Lemon Grass) Against Clinical Isolates of Multidrug-Resistant Acinetobacter Baumannii: A Preliminary In-Vitro Study.

Aim – In recent years, the incidence of nosocomial infections due to A.baumannii has increased to a point of concern. Rapid spread of multidrug and extremely drug resistant A.baumannii in clinical settings has made treatment options difficult for clinician. It has also increased the morbidity and mortality in immunocompromised patients. The aim of this study was to investigate the efficacy of essential oil of a traditional medicinal plant, Cymbopogon flexuosus (lemon grass) against the problematic multidrug resistant A.baumannii. Methodology – Essential oil of lemon grass was distilled by Neo-Clavenger’s method and the antibacterial activity was tested against 102 multidrug resistant A.baumannii clinical isolates by punch-well and disc diffusion methods. The minimum inhibitory concentration of lemon grass oil was determined by Macrobroth dilution method. Results – Majority of A.baumannii isolates were inhibited by lemon grass oil, inhibition zone ranging from 13mm to 33mm, mean inhibition zone being 23mm and the minimum inhibitory concentration of lemon grass oil was 6.25μl/ml. Conclusion – essential oil lemon grass showed good antibacterial activity against A.baumannii and might be considered as an alternative treatment option against multi-drug resistant A.baumannii infections. However, further pharmacokinetic and pharmacodynamic studies are needed for routine clinical use.

Antibacterial Activity of Essential Oil of Syzygium Aromaticum (L.) Merr.Perry (Cloves) Against Clinical Isolates of Aggregatibacter Actinomycetemcomitans.

Aim: Aggregatibacter actinomycetemcomitans implicated in the etiology of aggressive, chronic periodontitis and other systemic infections. The aim of this study was to investigate the antibacterial efficacy of essential oil of a traditional medicinal plant, Syzygium aromaticum (L.) Merr.perry (cloves) against the clinical isolates of A.actinomycetemcomitans obtained from the patients with orodental infections. Methodology: Essential oil of clove flower buds was distilled by Neo-Clevenger’s method and the antibacterial activity was tested by disc diffusion and agar punch well method. The minimum inhibitory concentration of clove oil was determined by micro broth dilution method. Results: 80.8% of the isolates showed sensitivity against clove oil by disc diffusion technique and the minimum inhibitory concentration of clove oil was ranged between 3.125μl/ml to 12.5μl/ml. Conclusion: Essential oil of Syzygium aromaticum showed good antibacterial activity and can be considered as alternative treatment option for control of periodontitis and other orodental infections caused by A.actinomycetemcomitans.

Prevalence of group b streptococcal colonization among pregnant women in a Tertiary Care Hospital on Coastal Karnataka.

The aim of our study was to evaluate maternal colonization with Group B Streptococci (GBS) which may predispose to adverse neonatal outcome. The study was carried out in a tertiary care hospital in Mangalore for a duration of one year. Duplicate sterile swabs of all samples from vagina of antenatal cases (35 to 37 wks gestation) who visited the Gynaecology OPD and wards were collected. Samples were transported without delay and cultured and identified by biochemical and agglutination tests. The antibiogram for the isolates were performed as per CLSI guidelines. Of the 349 antenatal cases screened during the third trimester for GBS colonization, 29 (8.31%) were found to harbour Group B Streptococcus. The different rates of colonization of GBS in the population has led to the conclusion of potential hazards to neonates among pregnant women warranting mandatory screening of not only vaginal but also urine and rectal samples to get a more reliable result leading to better early intrapartum treatment and safer neonatal outcomes.

Significance of direct smear examination for the diagnosis of female genital tract infections.

The present study is conducted to demonstrate the value of direct smear examinations ( Gram stain and wet mount ) of vaginal discharge from infected female patients. The diagnosis of bacterial vaginosis and other infections were carried out by direct gram stained smear and wet mount preparations of vaginal discharge in 1004 cases of various infections affecting these patients. Gram stain was a useful tool to pick up various infections of the genital tract and wet mount was helpful in detecting Trichomonas vaginalis. In short , direct smear examination will facilitate clinician in the diagnosis of female genital tract infections with minimum requirements.

Neomycin robertson’s cooked meat medium (N.RCM) for the selective isolation of anaerobes.

As Robertson’s cooked meat medium (RCM) promotes the simultaneous multiplication of facultative anaerobes along with anaerobes, it may be interfered with the isolation rate of anaerobes. In the present study RCM was made selective to overcome this difficulty by the incorporation of Neomycin. The efficacy of modified RCM was evaluated by growing stock cultures of various anaerobes and aerobes well as by inoculating clinical specimen directly and comparing the results with routine RCM. Among the 160 stock cultures of aerobes 8 of the 28 neomycin resistant aerobes grew in N.RCM but none of the 132 neomycin sensitive aerobes. Out of the 150 clinical samples tested in the study,77 anaerobes and 97 aerobes were isolated from routine RCM whereas 89 anaerobes and 8 Neomycin resistant aerobes from NRCM (i.e. NRCM inhibited 91.7% of aerobes and gave an increased yield of 13.5% anaerobes).These findings suggest that NRCM can be employed to suppress the aerobes and at the same time to enhance the isolation of anaerobes.

Salmonella wien from gastroenteritis cases encountered in Mangalore, India : A report of 10 cases and review of the literature.

Ten cases of gastroenteritis due to S. Wien were reported from a tertiary care hospital in Mangalore, in the month of April 2008. Biochemically, it resembles S. Paratyphi B or S. Typhimurium. Serotyping was done at the Central Research Institute, Kasauli, to confirm the identity. The food source is more likely to be chicken or some poultry products. All the 10 cases recovered with symptomatic treatment including antimicrobials like fluoroquinolones. To the best of our knowledge, no documented report is available from India regarding the prevalence of this organism in humans.

Osteomyelitis of the mandible due to Aggregatibacter (Actinobacillus) actinomycetemcomitans.

Aggregatibacter (Actinobacillus) actinomycetemcomitans is a capnoic gram negative coccobacilli known to produce juvenile periodontitis. This organism was isolated in pure culture from an unusual case of osteomyelitis of the mandible. The patient was treated with tetracycline, which is the drug of choice for A. actinomycetemcomitans and the clinical response improved. From our limited review of the literature, it appears that this is the first case of osteomyelitis due to A.actinomycetemcomitans reported in India.

Empyema thoracis due to actinomyces odontolyticus.

Actinomyces odontolyticus has been reported as an opportunistic pathogen causing systemic infections. A case of empyema thoracis due to this organism in a 68-year-old male is reported here. The patient did not have any underlying disease or immunosuppression. The organism was isolated from his oral flora also. Eight cases of thoracopulmonary infections due to A. odontolyticus have been reported from the western countries, but none from India.