Speciation, Biofilm Formation and Antifungal Susceptibility of Candida Isolates from Clinically Diagnosed Patient of UTI in a Tertiary Care Hospital.

INTRODUCTION: The incidence of the urinary tract infections caused by Candida species, are becoming more common. Recently, an increase in the incidence of infection caused by fungi especially non albicans candida species (NAC) has been reported. Several virulence factors like biofilm formation, toxin production and presence of adhesins contribute to its pathogenesis. OBJECTIVES: This study was undertaken to determine species distribution, biofilm formation and in-vitro antifungal susceptibility of candida isolated in our tertiary care hospital. METHOD: Eighty seven clinical isolates obtained from urine specimens were subjected to wet mount, Gram's stain and cultured on Sabouraud's Dextrose agar (SDA) medium. Conventional method for yeast identification was done. Biofilm forming ability of each isolate was detected using microtitre plate method. Antifungal susceptibility against posaconazole, amphotericin-B, fluconazole, itraconazole, ketoconazole, 5-flucytosine, voriconazole, and caspofungin was tested using Sensititre® Yeastone® (Trek diagnostic systems). RESULTS AND DISCUSSION: Out of 87 candida isolates, 31.03% (n=27) were C. albicans and 68.97% (n=60) were non albicans candida species (NAC). Among 60 NAC, C. kruseii 29.89% (n=26), C. glabrata 24.14% (n=21), C. tropicalis 14.94% (n=13). Among all isolates, 36.78% (n=32) were biofilm producers and biofilm positivity more among C. albicans 55.56% (n=15) as compared to NAC 28.33% (n=17) (Pvalue<0.002). The maximum positivity was observed with isolates from plastic devices (61.8%). The minimum inhibitory concentrations of all antifungal drugs against all isolates were within susceptible range except for fluconazole which was resistant to C. kruseii. CONCLUSION: C. albicans remains the major isolate from urine samples and also biofilm formation as a virulence factor might have a higher significance for C. albicans than for NAC and its ability to form biofilm is intricately linked with ability of organisms to adhere, colonize and subsequently cause infection.

Microbial community in packed bed bioreactor involved in nitrate remediation from low level radioactive waste.

Nitrate is the second largest contaminant of agriculture soil after pesticides. It also is a major pollutant from nuclear and metallurgical operations. Conventional methods for nitrate removal suffers from high cost and complexity leaving bioremediation as a viable alternative strategy. A pilot plant of 2.5 m(3)/day capacity has been functioning since 2005 based on microbial consortia treating actual effluent from nuclear power plant having pH of 7-8.5 (optimum) with N:C ratio of 1:1.7. The maximum biodegradable nitrate concentration of 3000 ppm could be reduced to below permissible limit (44.2 ppm) within 24 h in presence of sodium acetate as carbon source. Culture independent analysis (16S rDNA based) revealed clones having closest identity with uncultured bacterium, Pseudomonas stutzeri and Azoarcus sp. The existence of dissimilatory pathway of nitrate reduction in the community DNA is indicated by presence of nirS and nirK gene. Though the microbial mass was developed using municipal sewage, absence of Mycobacterium sp was confirmed using PCR. The understanding of the molecular identification of the consortium would help in developing the preservation strategy of the microbial mass for replication and perpetuation of the system.

Social Determinants and its Influence on the Prevalence of Morbidity among Adolescent Girls.

BACKGROUND: The adolescent girls are more vulnerable, particularly in developing countries including India, due to various adverse socio-cultural and economic reasons. Majority of the health problems affecting adolescent girls are preventable by promotion of hygienic practices through proper health education by the teachers. AIM: This study was designed to examine the various factors influencing the prevalence of morbidity among school-going adolescent girls of Lucknow district in north India. MATERIALS AND METHODS: A cross-sectional study was carried out in urban and rural schools of Lucknow district from 2008 to 2009. Multistage random sampling was used to select the requisite number of girls. A total of 847 adolescent girls between 10 and 19 years of age were interviewed, and information regarding their socio-demographic characteristics was collected and clinical examination was carried out. Statistical analyses were done using percentage and Chi-square test. RESULTS: Of 847 adolescent girls, around 64.8% were found to be sick at the time of the study. Significant association of morbidity was observed with caste, birth order, type of family, socioeconomic status (SES), living status with parents/guardian, and general personal hygiene (P<0.05). CONCLUSION: This study reveals a high prevalence of morbidity. A strong need exists for planning and programming intervention activities for health needs in the area.

Newborn Care Practices in Urban Slums of Lucknow City, UP.

OBJECTIVES: To study the knowledge and practices related to newborn care in urban slums of Lucknow city, UP, and to identify critical behaviors, practices, and barriers that influence the survival of newborns. MATERIALS AND METHODS: A cross-sectional study in urban slums of Lucknow city, UP, included 524 women who had a live birth during last 1 year preceding data collection. Data were analyzed using statistical software SPSS 10.0 for windows. RESULTS: Study findings showed that about half of the deliveries took place at home. Majority (77.1%) of the mothers believed that baby should be bathed with warm water and dried with clean cloth and 79.7% mothers practiced it. Only 36.6% mothers initiated breast-feeding within 1 h of birth and 30.2% initiated after 1 day. The mothers who have not given colostrum to their baby, in majority the reason was customs. CONCLUSION: In majority of cases, correct knowledge and correct practices regarding newborn care were lacking among mothers and this should be promoted through improved coverage with existing health services.

Cyclosporine in the treatment of severe steroid refractory ulcerative colitis: a retrospective analysis of 24 cases.

BACKGROUND: Cyclosporine A (CsA) has been found to be the first successful therapy used in the recovery of patients with steroid-refractory ulcerative colitis (UC). However, the long-term benefits of cyclosporine remain questionable. We report our results on the use of CsA in patients with severe steroid-refractory UC. METHODS: The records of all patients with steroid refractory UC treated with CsA from January 2003 to December 2007 were reviewed. Demographics, clinical characteristics of the disease, responsiveness to CsA, complications arising from the treatment and the need for surgery were recorded for all patients. RESULTS: Of 146 admissions of severe UC, 24 patients who were steroid refractory (mean age 41.7 years; 11 men) received intravenous cyclosporine (4 mg/kg/day) for mean of 6.63 days (range 1-7), followed by oral CsA for a period of 3 months. All patients had failed to respond to intravenous hydrocortisone given for 7 days. Four patients required a colectomy immediately, three of whom failed to respond to CsA, and one had convulsions following drug administration. Nineteen of the 24 patients (79%), in whom a colectomy was avoided during the early stages of their treatment, were followed up for a mean of approximately 38 months (range 12-62 months). Three patients required surgery on follow up; one was operated at day 94, another in the second year and one in the third year. Overall, 16 of 24 patients (67%) remained colectomy-free. The main side-effects observed included infections, tremors, paresthesias, headache, hypertension, hypertrichosis and peripheral neuropathy. Three of seven patients who had to undergo surgery died within 2 weeks. CONCLUSIONS: Our study shows that surgery can be avoided in two-thirds of patients with steroid refractive severe UC. However, the drug toxicity and mortality are significant.