Analysis of surface contamination of severe acute respiratory syndrome coronavirus 2 in a health-care setting in the context of the coronavirus disease-2019 pandemic.

BACKGROUND: Hospital-onset coronavirus disease-2019 (COVID-19) infection has been reported and is probably linked to ineffective implementation of infection prevention and control measures. Contaminated surfaces and air are considered a key part of the transmission dynamics of severe acute respiratory syndrome, Middle East respiratory syndrome, influenza, and other organisms in hospitals. This study aimed to assess the extent and persistence of surface contamination with COVID-19. MATERIALS AND METHODS: It was a hospital-based cross-sectional study conducted for a period for 2 weeks from December 03, 2020, to December 16, 2020, in Kathua district of J and K, India. The environmental samples were taken from the patient care area that included COVID isolation ward and intensive care unit (ICU) as per the guidelines of WHO Protocol "Surface sampling of COVID-19: A practical "how to" protocol for health care and public health professionals after seeking copyright permission from the WHO. Universal standard precautions were strictly followed. Descriptive analysis was done using the MS-Excel and expressed in numbers and percentages. RESULTS: A total of 140 surface samples were taken, 70 each from the COVID ICU and isolation ward. The results of ten samples from the ICU turned out to be positive and 20 samples were positive from the isolation ward. Eleven (78.6%) out of the 14 samples taken from the corners of the ICU and isolation ward were found to be positive. CONCLUSION: Our study revealed surface contamination in the hospital setting both in COVID ICU and isolation ward particularly from the corners of the COVID ICU and isolation ward followed by the samples taken from the linen. Strict adherence to COVID appropriate behavior, increased frequency of disinfection in high-risk areas, and sensitization of the staff are mandatory to minimize the infection risk.

Molecular identification of Candida species isolated from cases of neonatal candidemia using polymerase chain reaction-restriction fragment length polymorphism in a tertiary care hospital.

CONTEXT: Candida spp. is an emerging cause of bloodstream infections worldwide. Delay in speciation of Candida isolates by conventional methods and resistance to antifungal drugs in various Candida species are responsible for the increase in morbidity and mortality due to candidemia. Hence, the rapid identification of Candida isolates is very important for the proper management of patients with candidemia. AIMS: The aim was to re-evaluate the identification of various Candida spp. by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) and to evaluate the accuracy, speed, and cost of phenotypic methodology versus PCR-RFLP. SETTINGS AND DESIGN: Hospital-based cross-sectional study. MATERIALS AND METHODS: Ninety consecutive clinical isolates of seven Candida species, isolated from blood of neonates and identified by routine phenotypic methods, were re-evaluated using universal primers internal transcribed spacer 1 (ITS1) and ITS4 for PCR amplification and Msp I restriction enzyme for RFLP. STATISTICAL ANALYSIS USED: Kappa test for agreement. RESULTS: The results of PCR-RFLP were 100% in agreement with those obtained using conventional phenotypic methods. Identification could be achieved within 3 work days by both the methods. Our routine methods proved to be cost effective than PCR-RFLP. CONCLUSIONS: We can continue with our routine phenotypic methods and PCR-RFLP can be used for periodic quality control or when conventional methods fail to identify a species.

Hypertonic xylose agar medium: A novel medium for differentiation of Candida dubliniensis from Candida albicans.

BACKGROUND: Candida dubliniensis is a pathogenic Candida species which shares many phenotypic features with Candida albicans. These similarities have caused significant problems in the identification of C. dubliniensis in an average clinical mycology laboratory. Several phenotypic-based tests have been developed to distinguish C. albicans from C. dubliniensis but none has been demonstrated being sufficient alone for accurate differentiation of the two species. AIM: To facilitate the differentiation of these species, we evaluated the utility of a novel medium 'Hypertonic Xylose Agar Medium' (HXAM). MATERIALS AND METHODS: A total of 200 Candida spp. were tested in this study which included 186 stock strains of C. albicans and 14 strains of C. dubliniensis. Identification of all these strains was confirmed by polymerase chain reaction-restriction fragment length polymorphism using Bln I (Avr II) enzyme. All isolates were inoculated on HXAM, incubated at 28°C and examined for visible growth every day up to 7 days. RESULTS: On this medium at 28°C, all 186 C. albicans isolates showed visible growth at 48 h of incubation whereas none of the 14 C. dubliniensis isolates did so even on extending the incubation period up to 7 days. CONCLUSION: Hence, we propose HXAM as a sole phenotypic method for identifying C. dubliniensis from germ-tube-positive isolates or from stock collections of known C. albicans.

Rapid drug-susceptibility testing of Mycobacterium tuberculosis clinical isolates to first-line antitubercular drugs by nitrate reductase assay: A comparison with proportion method.

OBJECTIVE/BACKGROUND: Early initiation of therapy in patients with tuberculosis is imperative for its control. Conventional methods of susceptibility testing such as the proportion method (PM) require visual detection and counting of colonies that takes up to 6weeks. Rapid and simple phenotypic methods that have been endorsed by the World Health Organization can serve as alternatives. METHODS: In this study, we evaluated the colorimetric nitrate reductase assay, which utilizes the detection of nitrate reduction as an indicator of growth much earlier compared with PM (within 7-14days). The susceptibility of 75 clinical isolates of Mycobacterium tuberculosis to four first-line antitubercular drugs was tested by nitrate reductase assay and compared with the standard PM. In this assay, inoculation was done on both drug-free and drug-containing Löwenstein-Jensen medium containing sodium nitrate. After incubation for 7-14days, reduction to nitrite was taken as an indicator of growth, which was detected by color change on addition of Griess reagent. RESULTS: Agreement between nitrate reductase assay and PM was 100% for rifampicin, 97.30% for isoniazid, 93.30% for streptomycin, and 98.60% for ethambutol. Cost/isolate with this assay was found to be approximately two times lesser than that of PM. All results were obtained in 7-14days by nitrate reductase assay, which was significantly rapid compared with 42days taken for obtaining results by PM. CONCLUSION: Nitrate reductase assay can be used as a rapid and inexpensive method for drug-susceptibility testing of M. tuberculosis for first-line antitubercular drugs without compromising accuracy of standard methods.