A study on the circulating genotypes of hepatitis C virus in a tertiary care hospital in Central Kerala

Background: Hepatitis C is an emerging infection in India, which is known to progresses to liver cirrhosis and hepatocellular carcinoma. The persistence of chronic HCV infection is due to the existence of various genotypes and its various subtypes. There are seven different genotypes of HCV. These genotypes vary in their severity to cause infections as well as their response to treatment. Aim: This study aims at identifying the predominant genotypes of HCV in a population of patients presenting in a tertiary care center in Central Kerala. Settings and Design: This study was conducted at a tertiary care hospital and medical college, located in Central Kerala in the Department of Microbiology from January 2014 to June 2015.The sample size was 600 and a high risk group of patients attending the gastroenterology department, deaddiction centre and health care workers were screened. Materials and Methods: Serum samples were subjected to EIA, either rapid card or ELISA. Serum samples that were positive for HCV antibodies were confirmed by PCR. Twenty seven samples were positive for HCV antibodies by ELISA/rapid card, out of which 16 were confirmed by PCR. These 16 samples were subjected to gene sequencing to identify the genotype. Results: The prevalent genotypes isolated in this study was genotype 1, 3 and 4. Genotype 1 and 3 was predominantly seen transmitted by blood transfusions and multiple hemodialysis. The variability in laboratory parameters like SGOT and SGPT and its ratio with each genotype was also evaluated. Conclusion: To conclude, the occurrence of genotype 4 at a similar level to genotype 1 shows diffusion of new genotype in Kerala.

L-Phenylalanine and L-Tyrosine Catabolism by Thermophilic Geobacillus stearothermophilus.

Aims: This study investigated the potential of soil thermophile Geobacillus stearothermophilus for the biotransformation of phenylalanine and tyrosine. Study Design: G. Stearothermopilus grows well at 65ºC and has a good potential for transformation and biodegradation of many compounds including steroids, bile acids, tryptophan and other compounds. In this study G. stearothermophilus was harvested at mid-log phase at 65ºC, on tryptone yeast extract (TYE) medium. Cells were collected by centrifugation under aseptic conditions, washed with sterile water and suspended in phosphate buffer with phenylalanine or tyrosine as sole source of carbon at 65ºC. Metabolic parameters were optimized for optimal growth of the organism utilizing aromatic amino acids as an exclusive source of carbon. Methodology: The amino acid metabolites were exhaustively extracted with methanol from freeze dried broth. The concentrated pooled extracts were analyzed by thin layer chromatography (TLC) using polar solvent systems and purification of the extracts was achieved on preparative tlc plates and GC separations. The molecular structures of purified metabolites were established through spectral data. Results: Sixteen metabolites of phenylalainine and seventeen metabolites of tyrosine were identified in this study. Tyrosine metabolism extensively produced melanin pigments that caused hitches in the purification of tyrosine metabolites. Tyr metabolites were analyzed in cells cultured for short time. Conclusion: Our data suggest that G. stearothermophilus has a good potential to metabolize aromatic amino acids yielding hydroxylated, deaminated, decarboxylated and many other products. Oxidative metabolism of phenylalanine and tyrosine by a thermophilic G. stearothermophilus is being reported for the first time.

Cefotaximase and AmpC-producing Shigella flexneri in case of dysentery from southern India.

Diarrhoea and dysentery caused by Shigella spp. are major public health concerns. Emerging multidrug resistance (MDR) in this pathogen further complicates this disease. Extended spectrum β-lactamases (ESBLs) have been described in this pathogen, which significantly compromises the treatment options for shigellosis. The usual ESBLs seen are sulfhydryl variable (SHV)-type; cefotaximases (CTX-M) are very uncommonly detected. Here, we report a CTX-M type and AmpC-producing Shigella flexneri from a three-year-old boy residing in Central Kerala, South India.

Towards a rational antimicrobial testing policy in the laboratory.

Antimicrobial policy for prophylactic and therapeutic use of antimicrobials in a tertiary care setting has gained importance. A hospital's antimicrobial policy as laid down by its hospital infection control team needs to include inputs from the microbiology laboratory, besides the pharmacy and therapeutic committee. Therefore, it is of utmost importance that clinical microbiologists across India follow international guidelines and also take into account local settings, especially detection and presence of resistance enzymes. This article draws a framework for rational antimicrobial testing in our laboratories in tertiary care centers, from the Clinical and Laboratory Standards Institute guidelines. It does not address testing methodologies but suggests ways and means by which antimicrobial susceptibility reporting can be rendered meaningful not only to the treating physician but also to the resistance monitoring epidemiologist. It hopes to initiate some standardization in rational choice of antimicrobial testing in laboratories in the country pertaining to nonfastidious bacteria.

Mupirocin resistance in clinical isolates of staphylococci in a tertiary care centre in south India.

The present study was carried out to determine the rates of high-level and low-level mupirocin resistance in Staphylococcus spp. (MuH and MuL) in southern India. A prospective study was carried out on Staphylococcus spp. isolated for a period of three months in the microbiology laboratory of an 800-bedded tertiary care hospital. One hundred sixty-seven non-duplicate Staphylococcus spp. isolated from different specimens were tested for mupirocin susceptibility using 5 and 200 μg discs and by agar dilution. Rates of MuH were found to be two percent in methicillin-resistant Staphylococcus aureus (MRSA) and 28% in methicillin-resistant coagulase-negative Staphylococcus spp. (MRCoNS). MuL strains may be still treated with mupirocin, while MuH strains require other treatment options for eradication, making prior screening and differentiation important.

Acute pancreatitis in a child with idiopathic ulcerative colitis on long-term 5-aminosalicylic acid therapy.

Acute pancreatitis is a rare but known complication of inflammatory bowel disease in adults. In children, only a few cases with this complication have been reported. We describe a 10-year-old boy with ulcerative colitis who developed acute pancreatitis while on long-term treatment with 5-aminosalicylic acid.