Molecular epidemiology of methicillin resistant staphylococcus aureus colonizing the anterior Nares of school children of Udupi Taluk.

Context: Community associated methicillin resistant Staphylococcus aureus (CA‑MRSA) cause serious skin and soft tissue infections including necrotizing fasciitis and necrotizing pneumonia. Production of Panton Valentine Leucocidine (PVL) toxin is implicated in its enhanced virulence. A variant of epidemic MRSA‑15 (EMRSA‑15) which produces PVL toxin has been isolated and characterized by pulsed-field gel electrophoresis (PFGE) method from the Indian population both in hospital and community settings. Aims: Identify the epidemiological type of MRSA colonizing the anterior nares of school children in Udupi taluk. Settings and Design: The study population included children of the age group of 5-16 years belonging to the Udupi taluk of Karnataka, India. A total of 1503 children were screened for MRSA colonization during July 2009 to December 2010. Materials and Methods: PVL assay, Staphylococcal Cassette Chromosome (SCC) mec typing and PFGE typing were carried out with all the MRSA isolates. Statistical Analysis Used: Frequency distribution of different variables was assessed by SPSS. Results: Among the 1.1% of MRSA, 58.8% (10/17) of isolates were positive for pvl and 41.7% (7/17) were identified as SCC mec type IV. PFGE patterns of all the strains were identical with Indian variant EMRSA‑15; however they were different from classical EMRSA‑15 in 3-4 bands. Conclusions: The Indian variant EMRSA‑15 gains much epidemiological relevance owing to the acquisition of pvl gene. In spite of low prevalence of nasal colonization of MRSA, emergence of the virulent Indian variant EMRSA‑15 in our community is a worrisome fact to be reckoned with.

Exploring attributes of effective teachers - student perspectives from an Indian medical school.

Introduction: Attributes of an effective teacher is a passionate area of research for medical educators. Teaching at Melaka Manipal Medical College (MMMC), Manipal University, India, is assessed periodically as a part of the institution’s program evaluation process. The present study was undertaken to determine the highly rated attributes of a medical teacher, as felt by three batches (preclinical, para-clinical and clinical batch) of medical students at MMMC. Methods: A questionnaire focusing on twelve attributes of effective teaching was developed and administered to three batches of students. Students were requested to select the five most important attributes from the questionnaire and rank them accordingly as 1st, 2nd, 3rd, 4th and 5th. The responses were analyzed using cross tabulation and percentages of the grades provided by the participants were reported for each of the batch. Results: The ability of a teacher to motivate and inspire students was rated to be the best attribute of an effective teacher. Students also felt that defining objectives and clarifying concepts was an important quality that medical teachers should possess. The importance of being an effective communicator was also emphasized. Discussion: The present study underpins the need for a healthy teacher-student relationship in medical schools. Communication with international students in an Indian scenario may be a challenging task, keeping in mind the diverse cultural background of students. Probing qualities that students identify with an effective teacher may help us respond to these challenges.

Enhancing active learning in microbiology through case based learning: Experiences from an Indian medical school.

Background: Case-based learning (CBL) is an interactive student-centered exploration of real life situations. This paper describes the use of CBL as an educational strategy for promoting active learning in microbiology. Materials and Methods: CBL was introduced in the microbiology curriculum for the second year medical students after an orientation program for faculty and students. After intervention, the average student scores in CBL topics were compared with scores obtained in lecture topics. An attempt was also made to find the effect of CBL on the academic performance. Student and faculty perception on CBL were also recorded. Results: In a cross sectional survey conducted to assess the effectiveness of CBL, students responded that, apart from helping them acquire substantive knowledge in microbiology, CBL sessions enhanced their analytic, collaborative, and communication skills. The block examination scores in CBL topics were significantly higher than those obtained for lecture topics. Faculty rated the process to be highly effective in stimulating student interest and long term retention of microbiology knowledge. The student scores were significantly higher in the group that used CBL, compared to the group that had not used CBL as a learning strategy. Conclusion: Our experience indicated that CBL sessions enhanced active learning in microbiology. More frequent use of CBL sessions would not only help the student gain requisite knowledge in microbiology but also enhance their analytic and communication skills.

Inducible clindamycin resistance among clinical isolates of Staphylococci.

INTRODUCTION: Clinical failure of clindamycin therapy has been reported due to multiple mechanisms that confer resistance to macrolide, lincosamide and streptogramin antibiotics. This study was undertaken to detect the presence of inducible clindamycin resistance among clinical isolates of staphylococci. MATERIALS AND METHODS: The detection of inducible clindamycin resistance was performed by D-test using erythromycin and clindamycin discs as per CDC guidelines. RESULTS: Among the 244 clinical isolates of staphylococci studied, 32 (13.1%) showed inducible clindamycin resistance and belonged to the MLSBi phenotype. Among the MLS B i phenotypes, 10 isolates were methicillin-resistant Staphylococcus aureus (38.4% of the total MRSA), 16 were methicillin-sensitive Staphylococcus aureus (12.9% of the total MSSA) and 6 were coagulase-negative staphylococci (6.3% of the total CONS). CONCLUSION: The test for inducible resistance to clindamycin should be included in the routine antibiotic susceptibility testing, as it will help in guiding therapy.

Hepatic abscess caused by Salmonella typhi.

A 64 years diabetic man presented with recurrent episodes of fever and abdominal pain. Ultrasonography revealed the presence of an abscess in the right lobe of the liver and a distended gall bladder with multiple calculi. Salmonella typhi was grown from the liver aspirate. Cholelithiasis may act as a predisposing factor for hepatic abscess formation in Salmonella carriers.

Antibacterial activity of black tea (Camelia sinensis) extract against Salmonella serotypes causing enteric fever.

Alcoholic extract of black tea (Camelia sinensis) was assayed for its antibacterial activity against Salmonella serotypes causing enteric fever viz., Salmonella typhi and Salmonella paratyphi A. While all strains of S. paratyphi A tested were found sensitive, only 42.19% of S. typhi strains were inhibited by this extract. Further minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of black tea extract against S. paratyphi A was less compared with that against S. typhi.

Copper resistance & its correlation to multiple drug resistance in Salmonella typhi isolates from south Karnataka.

A study was conducted to ascertain the prevalence of copper resistant Salmonella typhi isolates in south Karnataka. Of the 186 strains studied, 26 (13.97%) were found to be copper resistant. Among the copper resistant strains 19 (73.08%) were found multi drug resistant. All copper resistant strains remained uniformly sensitive to ceftriaxone, ciprofloxacin and norfloxacin. Multiple drug resistance was exclusively associated with E1 phage types.

Drug resistance pattern and phage types of Salmonella typhi isolates in Manipal, South Karnataka.

Out of the 226 strains of S. typhi isolated over a period of three years 57.9% of them were multidrug resistant. 8.8% of the isolates were sensitive to all the drugs tested. A significant decline in hte number of multidrug resistant strains was observed in this region. Majority of the isolates belonged to phage type E (75.7%) and Biotype 1 (93.8%). All strains isolated were sensitive to ciprofloxacin, norfloxacin and ceftriaxone.