Intestinal helminthic infestation in children.

In this study of fecal samples from 1000 children below 6 years of age, 680 (68.0%) detected to have intestinal helminthic infection. The incidence of intestinal helminthiasis in urban group of children was 56.8% (284 out of 500 tested) while in rural group of children was 79.2% (396 out of 500 tested). Both in rural and urban population Ascaris lumbricoides was the single predominant species, whereas a combination of A. lumbricoides and Trichuris trichiura was common multiple infection. All cultures of fecal samples positive for hook worm ova revealed the prevalent species as Necator americanus in this area.

Trichomoniasis as sexually transmitted disease in sex partners.

Study of 30 male consorts of 30 cases of vaginal trichomoniasis with high levels of parasitic infection was undertaken to evaluate the sexually transmitted role of trichomoniasis in sex partners. There were 20 symptomatic and 10 asymptomatic male partners, who revealed T. vaginalis in 80.0% and 60.0 of the cases respectively and the overall prevalence was 73.3% (22 Of 30). T. vaginalis was detected in 83.3% male with urethritis and 50.0% males with prostatitis. Detection of trichomonas in urethral discharge, morning drop secretion, urine deposit and prostatic fluid was 80.0%, 50.0% 35.7% and 21.4% in that order. It is evident from these results that the sex consorts of all cases of trichomoniasis should be considered as harbouring T. vaginalis in their genito-urinary tract as carriers and be treated to break the chain of transmission. Fontanna smear was superior to culture and wet mount in the detection of T. vaginalis, the success rates being 73.3%, 63.3% and 53.3%. A good correlation was observed between smear and culture at high levels of parasitic infection.

Reservoirs of nosocomial pathogens in neonatal intensive care unit.

A total of 256 swabs taken from different areas of neonatal intensive care units (ICU) in KCG Hospital and AMC Hospital, Bangalore were bacteriologically investigated for prevalence, source and spread of nosocomial bacteria. Culture studies revealed growth in 217 (84.8%) swab samples indicating considerable contamination of different areas of the units and sources of infection. Klebsiella pneumoniae (27.3%) was the predominant organism followed by Esch coli (16.8%), Staph aureus (11.7%), Staph epidermidis and Pseudomonas aeruginosa (10.2%), enterococcus and proteus (4.7%), Citrobacter freundi (3.5%) and Clostridium tetani (2.4%) isolated from the equipment, cradles, other inanimate objects and environmental surfaces. Out of 312 isolates, monobacterial prevalence was 43.6% in contrast to polybacterial prevalence of 56.4%. Klebsiella pneumoniae (74.3%) was the predominant monobacterial isolate. The indoor air of the units was found to carry common nosocomial bacteria of 4 or more different bacterial species at dangerous levels as observed by colony counts of 15 to 30 on exposed blood agar plates. Almost all sources in ICU revealed the presence of Klebsiella Pneumoniae, Esch coli, pseudomonas and staphylococcus thus forming the potential reservoirs of nosocomial infections to babies and this could be attributed to overcrowding, poor ventilation system and failure to follow basic principles of strict protective barrier nursing.

Study of burn sepsis with special reference to Pseudomonas aeruginosa.

Fifty cases of burn of different degrees were subjected to clinical and microbiological studies. A total of 60 isolates were obtained. Of these, 40 (80.0% incidences) were Ps aeruginosa, 8 (16.0 incidences) Staph pyogenes, 6 (12.0% incidences) Kl pneumoniae, 4 (80.0% incidences) Esch coli and 2 (4.0% incidences) C albicans. Monobacterial cultures showed isolations in 41 cases (82.0%) and 34 (68.0%) of them were Ps aeruginosa. At the time to admission 42 cases (84.0%) were infected and during one week of hospitalisation another 8 cases (16.0%) were infected yielding an overall infection rate of 100%. The commonest organism on admission and after hospitalisation was Ps aeruginosa with isolation rates of 60.0% (30) and 20.0% (10) respectively. Gram-negative bacilli, predominantly Ps aeruginosa were found in the lower part of the body with an incidence of 74.0% (37). Staph pyogenes was found in the upper half showing an incidence of 12.0% (6) next to 20.0% (10) incidence of Ps aeruginosa. The incidence of burn infection was high in patients with deep and major burn wounds, the bacterial isolates being 76.0% (38) and 80.0% (40) respectively. Silver sulphadiazine exhibited antimicrobial action in the range of 14 to 390 microM/ml, while cerium sulphadiazine had no inhibitory effect even up to 667 microM/ml on pseudomonas isolates. Zinc sulphadiazine was effective in inhibiting the growth of 10 isolates tested in 40 to 297 microM/ml range.

An outbreak of multidrug resistant typhoid fever in Bangalore.

Six hundred and eighty five blood cultures from children clinically diagnosed as enteric fever yielded 176 salmonella strains showing isolation success rate of 25.7%, S. typhi were 164 (93.2%), S. paratyphi A 5 (2.8%), S. choleraesuis 4 (2.3%) and S. typhimurium 3 (1.7%). Antibiogram of 164 isolates of S. typhi showed triple drug resistance (TDR) in 156 strains (95.1%) to chloramphenicol, ampicillin and cotrimoxazole, and sensitivity of 90.2% and 95.1% to norfloxacin and ciprofloxacin respectively. Minimum inhibitory concentrations (MIC) of chloramphenicol were between 360 mcg and 640 mcg per ml. Phage types of 38 strains of TDR S. typhi were predominantly E1 and 0 with prevalences of 47.4% and 36.8% respectively in this region. All children with S. typhi isolates sensitive to quinolones in Vitro responded well to these drugs with almost no relapse and hence, the newer generation of quinolones could be considered as the first choice in the primary treatment of enteric fever.

Multidrug resistant Salmonella typhi in Bangalore, south India.

A total of 204 strains of salmonella were isolated in blood cultures during the year 1991 outbreak of enteric fever in and around Bangalore. Out of this, 190 were S. typhi, 6 S. paratyphi A, 5 S. typhimurium and 3 S. choloraesuis. Antibiogram of 190 strains of S. typhi showed resistance of 94.7%, 95.8% and 96.9% to chloramphenicol, ampicillin and cotrimoxazole and sensitivity of 65.3%, 88.4% and 94.2% to gentamycin, norfloxacin and ciprofloxacin respectively. Minimum inhibitory concentrations (MIC) of chloramphenicol were between 360 mcg and 640 mcg per ml. There was high degree (94.7%) of triple drug resistance to chloramphenicol, ampicillin and cotrimoxazole.

Haemolysins of Vibrio parahaemolyticus strains passaged in mice.

Some phenotypically non-haemolytic strains of V. parahaemolyticus were observed to produce haemolysins after two passages in mices. Depending on the strain, both heat stable and heat labile haemolysins were induced. The heat stable haemolysin so induced, was immunologically different from the thermostable direct haemolysin produced by Kanagawa positive strains of V. parahaemolyticus.

Bacillemia and Its Relationship with Bacteriological Index in Leprosy.

Detection of bacillemia in 40 untreated cases of leprosy was carried out by buffy coat. haemolysis and Petroff's concentration method. Bacillemiawas detected in 17 (42.5%) cases by Petroff's method. Out of 20 LL-BL cases, it was positive in 16 (80%) patients. Petroff's and haemolysis methods revealed bacillemia in 100% and 90% of LL cases respectively. The Petroff's method of concentration was found superior over the other techniques for better detection and quantitatioxi of bacffemia. A significant relationship between the bacillary load (BI) in the skin and the degree of bacillemia was observed especially in the lepromatous part of the spectrum of the dise4se.

Skin Tests for Evaluation of Cell Mediated Immunity in Leprosy.

Cell-meate,d immune (CMI) response to lepromin and dinitrochloro benzene (DNCB) was evaluatt-d in 60 freshly detected leprosy cases. It was observed that 70%, ( 28 of 40 ) of the pa across tie leprosy spectrum except LL cases revealed delayed hypersensitivity to DNCB as -against 42.5% (1-7 of 40) to lepromin. DNCB test was found superior to lepromin test to measure CMI because of its simplicity and easy interpretation of skin reactivity. It detected CMI in 40% of BL cases who were lepromin negative. Grading of skin reactivity showed a program decrease in delayed hypersensitivity across the spectrum of leprosy from TT to LL. It can be concluded that there is no gross impairment of non-specific CMI in leprosy patients other than LL cases and this non-specific CMI depression correlates well with Ridley-Jopling clinical scale of leprosy.

The role of trace elements and phosphates in the synthesis of vascular-permeability factor by Vibrio cholerae.

Trace element and phosphate requirements for the synthesis of vascular-permeability factor (PF) by Vibrio cholerae strains B1307 and VC12 were investigated. While magnesium appeared to be indispensable for strain VC12, small amounts of PF were synthesised by strain B1307 in the presence of iron, zinc and manganese. However, even in the latter strain, maximum synthesis was recorded only in magnesium-containing media. Phosphates in the range 0.75-6.00mM controlled the synthesis of PF by both strains.