prevalence of intestinal parasitic infections in the urban slums of a city in Western India

There is scant information available on the prevalence of parasitic infections in Gujarat, a state in Western India. The present community-based study was undertaken in the urban slums of a city in Gujarat to determine the following parameters: [a] the prevalence and type of pathogenic intestinal parasites and [b] the availability of sanitary facilities in the study population. This cross-sectional study was conducted in 2008, and the study participants were urban slum dwellers. Considering an expected infection prevalence of 30% among slum dwellers, an allowable error of 10% and an anticipated design effect of two, the sample size for the cluster design was set to 1800 participants from 30 clusters and 360 households [HHs]. Stool samples were examined using both direct wet mount and the formalin-ether sedimentation concentration technique, followed by trichrome staining for protozoan cysts. Toilet facilities were utilized by 56% of the HHs, while 44% of the HHs resorted to open air defecation. The overall prevalence rate of intestinal parasitic infections was 15.19%. Parasitic infections due to protozoa were observed in 70.71% of the study participants. Helminth infections were detected in 25.71% of the participants, and multiple parasitic infections were detected in 3.57%. Diarrhea was the most common complaint [9.56%] in the study population. This study demonstrates that poor sanitation and inadequate environmental conditions are the main determining factors that predispose the population to intestinal parasites. Mass deworming programs are recommended for school children, as this population is easily accessible

Extended spectrum b lactamases (ESBL) in clinical isolates of Klebsiella pneumoniae and Escherichia coli.

The present study was conducted to find the prevalence of Extended spectrum b Lactamase (ESBL) producing strains of Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. Coli) in different clinical samples received at the Department of Microbiology, Medical College Baroda. A total of 187 clinical isolates (106 of K. pneumoniae and 81 of E. Coli) were tested for resistance to any one of the three Third generation cephalosporins (3GC) namely cefotaxime, ceftazidime and ceftriaxone. 100 isolates (57 of K. pneumoniae and 43 of E. Coli) were found to be resistant to at least one of the 3GC tested. These were then tested for ESBL production by Double Disc Diffusion Synergy Test (DDST) using Ceftriaxone, Ceftazidime, and Cefotaxime along with Augmentin as well as by the MIC reduction test. ESBL was detected in 53 isolates (33 K. pneumoniae and 20 E. coli). Using the interpretative guidelines of the NCCLS, 24% to 27% of the ESBL isolates would have been reported to be susceptible to the 3GC by routine antimicrobial susceptibility methods. DDST was found to be a useful, simple and cost effective test for the detection of ESBL producing strains.

Eumycetoma due to Madurella grisea--a case report.

Mycetoma due to Madurella grisea has not been previously reported from Gujarat. We report a case in whom identification of the strain was made through the structure and texture of grains, morphology in Sabouraud's dextrose agar and histopathology.

Spinal tuberculosis due to dissemination of atypical mycobacteria.

There has been an increase in disease caused by Non Tuberculous Mycobacteria (NTM) since the early 1980s. Though ubiquitous in environment, they may act as clinically important pathogens in various conditions. More importantly they are resistant to the conventional anti-tuberculous therapy (ATT) and respond to antibiotics such as quinolones and aminoglycosides and need an aggressive surgical intervention. Missing these atypical mycobacteria may lead to unnecessary administration of ATT and hence delay in proper management of the case. We report a case of spinal tuberculosis due to a Non Tuberculous Mycobacteria, M. fortuitum (Rapid grower). Relevant literature is also reviewed.