Case Series to Depict the Outcomes of Commonly Available Laboratory Investigations in Molluscum-Like Skin Lesions among HIV Positive Patients.

Molluscum-like skin lesions in HIV patients can be the presenting feature of the vast array of diseases. Hence, laboratory investigations play a crucial role in making an accurate etiological diagnosis. The studies that discuss the outcomes of commonly performed laboratory tests in molluscum-like lesions in HIV patients are very sparse. Hence, we conducted a study to bridge this literature gap. This study was conducted among four patients with HIV who had molluscum-like skin lesions. Shave biopsy was performed on all the patients and the specimens were sent for potassium hydroxide (KOH) mount/gram stain, fungal culture and histopathological examination. The tissue samples from cases 1, 2, 3 and 4 are mentioned as samples A, B, C and D, respectively. KOH mount showed yeast-like rounded bodies around 6 µm in size in samples A and B. The KOH mount in samples C and D showed septate branching hyphae. KOH mount in sample C also showed large rounded bodies around 35 µm which were identified as molluscum bodies. The histopathology of samples A and B showed features suggestive of talaromycosis whereas the histopathology of samples C and D showed features of molluscum contagiosum. Culture in Sabouraud Dextrose Agar grew T. marneffei in samples A, B and C. The commonly available laboratory tests immensely help in establishing the diagnosis of molluscum-like skin lesions. However, certain nuances in laboratory tests need to be understood lucidly. Studies with larger sample sizes need to be conducted to determine the possible co-infection of poxvirus and T. marneffei, as witnessed in sample C.

Vaccination and COVID-19 infection among adults aged 45 years and above in a North-Eastern state of India.

Background: In response to this coronavirus disease 2019 (COVID-19) pandemic, vaccines reaching the predetermined levels of safety and efficacy were rolled out for use under emergency use approval/listing (EUA/EUL). The government of India has introduced three vaccines for emergency use as of today. Aim: The study was conducted to evaluate the association between the Covishield vaccine and COVID-19 infection among adults (≥45 years) who undergo reverse transcription-polymerase chain reaction (RT-PCR) COVID-19 testing. Methods: The study was conducted in a dedicated COVID-19 hospital in a north-eastern state of India among adults aged 45 years and above, who underwent RT-PCR testing. Cases were those who tested positive for RT-PCR and controls were those who were RT-PCR negative during the same period. A structured questionnaire was used to collect relevant data pertaining to socio-demographic profile, symptoms of COVID-19, vaccination status, co-morbidities, etc. Multiple logistic regression was used to calculate the odds ratio (OR) to find the association between vaccination and COVID-19 infection. Results: A total of 116 participants, 45 years and above were interviewed in the study. It was found that cases were more likely to have symptoms (48% vs. 6.9%, P value = <0.005) and have history of positive family member (89.7% vs. 72.4%, P value = 0.018) than controls. The odds of having COVID-19 infection were OR 12.60 (95% confidence interval (CI) 4.03-39.34) for those that have symptoms and OR 6.07 (95% CI 1.90-19.34) for unvaccinated individuals. Conclusions: Covishield vaccine protected individuals against COVID-19 infection with the risk of getting the infection being significantly lower in vaccinated individuals. Relevance for Patients: COVID-19 vaccination prevents the infection and addresses misconceptions about the vaccine.

Comparative transcriptome analysis of SARS-CoV, MERS-CoV, and SARS-CoV-2 to identify potential pathways for drug repurposing.

The ongoing COVID-19 pandemic caused by the coronavirus, SARS-CoV-2, has already caused in excess of 1.25 million deaths worldwide, and the number is increasing. Knowledge of the host transcriptional response against this virus and how the pathways are activated or suppressed compared to other human coronaviruses (SARS-CoV, MERS-CoV) that caused outbreaks previously can help in the identification of potential drugs for the treatment of COVID-19. Hence, we used time point meta-analysis to investigate available SARS-CoV and MERS-CoV in-vitro transcriptome datasets in order to identify the significant genes and pathways that are dysregulated at each time point. The subsequent over-representation analysis (ORA) revealed that several pathways are significantly dysregulated at each time point after both SARS-CoV and MERS-CoV infection. We also performed gene set enrichment analyses of SARS-CoV and MERS-CoV with that of SARS-CoV-2 at the same time point and cell line, the results of which revealed that common pathways are activated and suppressed in all three coronaviruses. Furthermore, an analysis of an in-vivo transcriptomic dataset of COVID-19 patients showed that similar pathways are enriched to those identified in the earlier analyses. Based on these findings, a drug repurposing analysis was performed to identify potential drug candidates for combating COVID-19.

Outbreak of Burkholderia Cepacia Infection: a Systematic Study in a Hematolooncology Unit of a Tertiary Care Hospital from Eastern India.

BACKGROUND: Burkholderia cepacia, an aerobic gram-negative bacillus, is a frequent colonizer of fluids used in the hospital ward. It poses little risk of infection to healthy people; however it is a known important opportunistic pathogen causing morbidity and mortality due to its intrinsic resistance to most of the antibiotics in hospitalized patients. Small hospital outbreaks are frequent. B. cepacia may occur as an opportunistic infection in hemato-oncology patients. Here we present an outbreak of Burkholderia cepacia infection in hematology ward of our institute. METHODS: Febrile episodes as defined by IDSA guideline, 2010 were followed, and blood for culture and sensitivity was sent in all the events. The culture was done by an automated method using Bactalert 3d Biomeriux & sensitivity pattern by Microscan Siemens method and subsequently detected by PCR based method. RESULTS: During September 2016 to February 2017 (six months), a total of 498 blood cultures were sent during febrile episodes. Out of which 60 (12%) came out to be positive for different microorganisms. Out of all positive cultures, Burkholderia cepacia was detected in 29 (48%) patients, which reduced drastically following the change in antibiotic administration practice. All isolates showed sensitivity to pipercillin+tazobactum, cefoperazone+sulbactum, fluoroquinolones, cotrimoxazole and carbapenems and resistance to polymyxin B and colistin. With timely intervention by appropriate intravenous antibiotics as per culture sensitivity result and change in antibiotic preparation practice, overall mortality was low 1 (4%) out of 29 culture positive episodes. CONCLUSION: Change of antibiotic preparation practice was the key to control this outbreak, and overall mortality was low.