Emergence of Vibrio cholerae serogroup 0139 in Haryana in May-June 1993.

In an outbreak of acute watery diarrhoea, 11 strains of V. cholerae were isolated in May-June 1993 at Medical College, Rohtak. Eight of these belonged to serogroup Ogawa and three were identified as V. cholerae serogroup 0139. This is the first report of isolation of this novel serotype from this region.

Clinico-haematological profile in acute and chronic Plasmodium falciparum malaria in children.

The clinicohaematological findings of acute state (Group A, 30 patients) and chronic state (Group B, 34 patients) of falciparum malaria in paediatric patients are compared. The children with chronic falciparum malaria were apyrexic and presented with features of moderate to severe anaemia with hepato-splenomegaly. Greater severity of anaemia and haemolysis, higher incidence and severity of neutropenia, atypical lymphocytosis, monocytosis and thrombocytopenia were observed in patients with chronic falciparum malaria as compared to patients with acute falciparum malaria despite lesser degree of parasitaemia in the former as compared to the latter. While mechanical destruction of parasitised RBC's, ineffective and dysplastic erythropoiesis either due to unmasking of border line dierty folic acid deficiency or otherwise, transient hypoplasia of bone marrow, impaired utilization of iron and immune destruction of RBCs with hypersplenism may be the mechanisms for anaemia, transient hypoplasia of bone marrow and hypersplenism may be the factors responsible for thrombocytopenia and neutropenia.

Bacillaemia and bone marrow involvement in leprosy.

Fifty patients (24 new and 26 receiving specific treatment) of leprosy were investigated to study the concentration and morphological index (MI) of the lepra bacilli in skin, peripheral blood and bone marrow. The organisms were detected in 28 cases on skin slit smear examination, in 38 cases on bone marrow examination and in 38 cases on examination of smears made from buffy coat of peripheral blood. Out of 22 cases negative for the bacilli on skin slit smears, 15 had the organisms either in buffy coat or bone marrow or both. Acid fast bacilli in peripheral blood and bone marrow with skin smear negativity were mainly observed in patients with paucibacillary type of the disease and in those who were receiving treatment. Examination of buffy coat and bone marrow for presence of lepra bacilli is suggested to establish the diagnosis in doubtful cases.

Resistotyping as a new epidemiological marker for Klebsiella pneumoniae.

Resistogram typing was established with the help of 30 randomly chosen clinical isolates of K. pneumoniae using sodium arsenate, malachite green, boric acid, potassium tellurite, mercuric chloride, antimony potassium tartarate and sodium arsenite. The resistance to these chemicals was designated as A, B, C, D, E, F and G respectively. The technique was then applied to 152 clinical isolates of K. pneumoniae. A total of 35 patterns were obtained. Common patterns were ABEFG and ABFG. There was no clustering of the strains in any of the resistogram patterns as even the commonest pattern had only 10.5 per cent of the strains. When combined with klebocin typing, it provided better discrimination of strains as strains belonging to seven klebocin types could be subdivided into 68 resistogram patterns. The reverse was also possible, i.e., the strains belonging to seven resistogram patterns could be subdivided into 38 klebocin types. The former procedure thus offered better discrimination of the strains.

Association of R plasmids of Klebsiella pneumoniae with resistance to heavy metals, klebocin and beta lactamase production and lactose fermentation.

One hundred and fifty clinical isolates of Klebsiella pneumoniae were studied for beta lactamase production, Klebocin production and resistance to antibiotics and metals. 97.3 and 82.7 per cent strains produced beta-lactamase and klebocin respectively. Resistance to arsenite, antimony, tellurite, mercury and silver was observed in 91,66,6, 47.7, 44.8 and 33.3 per cent respectively and to ampicillin, tetracycline and nalidixic acid in 93.3,60, 41.3, 34.4, 28.2, and 1.3 per cent respectively. Forty eight antibiotic and metal resistant strains were then conjugated with Escherichia coli 711 F-Lac-Nxr. Transferable drug resistance, metal ion resistance, beta lactamase production, klebocin production and lactose fermentation was seen in 30, 21, 10, 11 and 5 isolates respectively.