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1.
Heliyon ; 10(10): e31232, 2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38813207

RESUMO

Gangetic old alluvial zone in India has conserved many locally adapted aromatic rice landraces. In order to determine the extent of genetic divergence of ten morphological characters, the study was conducted to examine forty-eight aromatic rice genotypes for six Kharif seasons (2016-2021) at the Instructional Farm of Regional Research Station (Old Alluvial Zone), Uttar Banga Krishi Viswavidyalaya, Majhian, West Bengal, India. The experiment was laid out in Randomized Complete Block Design (RCBD) with three replications. A considerable degree of variation was noted for all the traits being investigated. It was found that the total number of tillers per plant, panicle numbers per plant, number of grains per panicle, fertility percentage, test weight, and grain length/breadth ratio had significantly positive correlated with seed yield per plant. Based on D2 analysis values, all the genotypes were grouped into six clusters. Cluster III (Tulaipanji, Patnai, Basmati 1121, Jugal, and Bahurupi) and Cluster VI (Kanakchur), containing genotypes were found most divergent with maximum inter-cluster distance (6941.51). According to the cluster means, Cluster II had the largest intra-cluster distance (1937.52), and important attributes including test weight, number of grains per panicle, seed yield per plant, and fertility percentage made remarkably significant contributions to this cluster. In terms of principal component analysis, maximum variability was found in PC1 (23.88 %), with high positive loading values for tillers per plant (0.459), panicle number per plant (0.441), seed yield per plant (0.408), fertility percentage (0.364), test weight (0.264), and grain length/breadth (L/B) ratio (0.263). On the basis of biplot analysis, four genotypes, namely Shakbhati, Sugandhi, Bahurupi and Kanakchur, were identified as the most divergent types for the yield-attributing traits of aromatic rice. The diverse genotypes could be used as potential donors in future breeding programmes.

2.
Indian J Med Microbiol ; 48: 100565, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38522746

RESUMO

PURPOSE: Drug-resistant Acinetobacter baumannii is an emerging threat. This study has been conducted to observe the efficacy of eravacycline along with the RND-efflux pump system. METHODS: A cross-sectional study was done collecting 48 clinical isolates of Acinetobacter baumannii. MICs of 15 antibiotics were detected along with BMD of tigecycline and eravacycline. PCR products of drug-resistant regulatory genes were sequenced and analyzed. RESULTS: Of the total 48 Isolates, 35 (72.91%) were XDR and 13 (27.08%) were MDR. Out of all, 60.41% of isolates were found to be susceptible to eravacycline by BMD according to both FDA and EUCAST guidelines. A 2-fold decline of MIC50/90 was observed with the use of eravacycline compared to tigecycline. RND-efflux genes like AdeC in 30 (62.5%) isolates and Regulatory gene AdeS in 29 (60.41%) isolates were detected, explaining the existing resistance mechanism. CONCLUSIONS: XDR Acinetobacter poses an escalating threat due to its resistance to multiple antibiotics, raising serious concerns in healthcare settings. Eravacycline is an encouraging new drug for empirical use in severe infection caused due to the same. Molecular investigation and strict antimicrobial stewardship should be followed to control the emergence, and a better understanding of mechanisms of resistance to prevent the spread of drug-resistant isolates.


Assuntos
Infecções por Acinetobacter , Acinetobacter baumannii , Antibacterianos , Farmacorresistência Bacteriana Múltipla , Testes de Sensibilidade Microbiana , Tetraciclinas , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/genética , Acinetobacter baumannii/isolamento & purificação , Humanos , Antibacterianos/farmacologia , Tetraciclinas/farmacologia , Infecções por Acinetobacter/microbiologia , Estudos Transversais , Tigeciclina/farmacologia , Proteínas de Bactérias/genética , Proteínas de Membrana Transportadoras/genética
3.
J Clin Microbiol ; 62(3): e0104823, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38329335

RESUMO

Human granulocytic anaplasmosis (HGA) is an emerging, rickettsial tick-borne disease caused by Anaplasma phagocytophilum. Sero-epidemiological data demonstrate that this pathogen has a worldwide distribution. The diagnosis of HGA requires a high index of clinical suspicion, even in endemic areas. In recent years, HGA has increasingly been reported from Asia and described in China, Japan, and Korea. We serologically and molecularly screened 467 patients with clinical suspicion of Anaplasmosis. The present study describes the epidemiology, clinical, and laboratory details of 6 confirmed and 43 probable cases of human granulocytic anaplasmosis. One of the HGA patients developed secondary invasive opportunistic Aspergillus fumigatus and Acinetobacter baumanii infection during the illness, which resulted in a fatal infection. The HGA patients without severe complications had excellent treatment responses to doxycycline. The emergence of this newly recognized tick-borne zoonotic HGA in North India is a significant concern for public health and is likely underdiagnosed, underreported, and untreated. Hence, it is also essential to establish a well-coordinated system for actively conducting tick surveillance, especially in the forested areas of the country.IMPORTANCEThe results of the present study show the clinical and laboratory evidence of autochthonous cases of Anaplasma phagocytophilum in North India. The results suggest the possibility of underdiagnosis of HGA in this geographical area. One of the HGA patients developed secondary invasive opportunistic Aspergillus fumigatus and Acinetobacter baumanii infection during the illness, which resulted in a fatal infection.


Assuntos
Anaplasma phagocytophilum , Anaplasmose , Doenças Transmitidas por Carrapatos , Animais , Humanos , Anaplasmose/diagnóstico , Anaplasmose/tratamento farmacológico , Anaplasmose/epidemiologia , Doxiciclina/uso terapêutico , China/epidemiologia , Índia
4.
Plant Physiol Biochem ; 207: 108388, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38295528

RESUMO

Grass pea has the potential to become a miracle crop if the stigma attached to it as a toxic plant is ignored. In light of the following, we conducted transcriptome analyses on the high and low ODAP-containing cultivars i.e., Nirmal and Bidhan respectively in both normal and salt stress conditions. In this study, genes that work upstream and downstream to ß-ODAP have been found. Among these genes, AAO3 and ACL5 were related to ABA and polyamine biosynthesis, showing the relevance of ABA and polyamines in boosting the ß-ODAP content in Nirmal. Elevated ß-ODAP levels in salt stress-treated Bidhan may have evolved tolerance by positively regulating the expression of genes involved in phenylpropanoid and jasmonic acid biosynthesis. Although the concentration of ß-ODAP in Bidhan increased under salt stress, it was lower than in stress-treated Nirmal. Despite this, the expression of stress-related genes that work downstream to ß-ODAP was found higher in stress-treated Bidhan. This could be because stress-treated Nirmal has lower GSH, proline, and higher H2O2, resulting in the development of severe oxidative stress. Overall, our research not only identified new genes linked with ß-ODAP, but also revealed the molecular mechanism by which a low ß-ODAP-containing cultivar developed tolerance against salinity stress.


Assuntos
Diamino Aminoácidos , Lathyrus , Lathyrus/genética , Lathyrus/metabolismo , Neurotoxinas/análise , Neurotoxinas/metabolismo , Diamino Aminoácidos/análise , Diamino Aminoácidos/metabolismo , Peróxido de Hidrogênio/metabolismo , Estresse Salino/genética
7.
Indian J Med Microbiol ; 47: 100493, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37890414

RESUMO

INTRODUCTION: The development of aminoglycoside modifying enzymes (AMEs) and increased efflux activity are considered important aminoglycosides resistance mechanisms. AIM: This study is focused on the detection of the AMEs gene and assessing the effect of efflux pump inhibitor on the reversal of A. baumannii drug susceptibility. METHODOLOGY: Bacterial DNA was amplified using AMEs gene-specific primers. Isolates were also investigated for efflux pump activity using efflux pump inhibitor (EPI) i.e. Carbonyl cyanide m-chlorophenyl hydrazone (CCCP) and the impact of both mechanisms was analyzed. RESULTS: Among A. baumannii isolates, 55% isolates (n â€‹= â€‹22/40) were identified to have aminoglycoside modifying enzymes genes; ant(3')-I gene (50%, 11/22), aac(6')-Ib gene (45.4%, 10/22), aph(3')-I gene (18.1%, 4/22) and aac(3)-I (9.1%, 2/22). Total 70% isolates have shown MIC alteration in different classes of drugs in response to EPI-CCCP. Such alteration was found in 100% amikacin sensitive and 58.6% amikacin resistant, 93.7% and 57.1% gentamicin sensitive and resistant isolates respectively. CONCLUSION: The presence of aminoglycosides modifying enzymes was frequent among aminoglycosides resistant A. baumannii isolates and the coexistence of efflux pumps activity also plays an important role to increase drug resistance. REPOSITORIES: Genbank and their accession numbers are MT903331[aac(3)-I], MT903332 MT903333 [ant(3')-I], MT903334, MT903335 [aph(3')-I)] and MT903336, MT940242 [ aac(6')-Ib].


Assuntos
Acinetobacter baumannii , Aminoglicosídeos , Humanos , Aminoglicosídeos/farmacologia , Amicacina/farmacologia , Carbonil Cianeto m-Clorofenil Hidrazona/farmacologia , Farmacorresistência Bacteriana/genética , Antibacterianos/farmacologia , Testes de Sensibilidade Microbiana
8.
Trop Doct ; 54(1): 7-8, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37844878

RESUMO

Standard urine culture is the gold standard for diagnosing urinary tract infections (UTIs) but fails to differentiate true UTI from asymptomatic bacteriuria, which is important to prevent the overuse of antibiotics. Correlation with the presence or absence of pyuria can be helpful in giving a hint of the true situation. With the help of Laboratory Information System (LIS), patients' urinalysis reports can be conveniently accessed and compared simultaneously with appropriate reports. In our study, a quality improvement initiative was planned for appropriate reporting of urine culture and antimicrobial susceptibility testing using information obtained through LIS.


Assuntos
Bacteriúria , Sistemas de Informação em Laboratório Clínico , Infecções Urinárias , Humanos , Melhoria de Qualidade , Infecções Urinárias/diagnóstico , Urinálise , Bacteriúria/diagnóstico
10.
Indian J Microbiol ; 63(3): 369-372, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37781012

RESUMO

Post vaccination with Covaxin (BBV152), Serum from healthcare professionals of Microbiology Department at apex tertiary referral hospital of India were tested for SARS-CoV-2 specific IgG antibodies. 70% individuals at 14-30 days, 63.1% individuals at 30-60 days but only 36.8% individuals at 60-90 days after second dose of vaccine had detectable SARS-CoV-2 spike protein specific IgG antibodies. However, 80% individuals at 14-30 days, 89.4% individuals at 30-60 days while 94.7% individuals at 60-90 days after second dose of vaccine had detectable SARS-CoV-2 whole cell antigen specific IgG antibodies. Males were lacking SARS-CoV-2 spike protein specific IgG antibodies in higher proportion than females and had lower index wherever detected. Age and co-morbidities were non-significant factors for post vaccination IgG response but not in breakthrough infection. 8.3% individuals developed mild COVID-19 symptoms post 14-90 days of second dose and none had severe COVID-19. SARS-CoV-2 spike protein specific IgG antibodies induced by Covaxin are drastically reduced in 60-90 days among fully vaccinated individuals which could be a potential risk for breakthrough SARS-CoV-2 infection, if not severe COVID-19. It may be essential to have additional antigenic stimulations/boosters for continued protection.

11.
Indian J Med Microbiol ; 46: 100471, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37699292

RESUMO

BACKGROUND: Rickettsial pathogens are Gram-negative, obligate intracellular bacteria. They are transmitted by arthropods and are responsible for a wide variety of disease, from minor to life-threatening, which have a global effect on human health. Limited data are available on the prevalence of rickettsial diseases from India, and the disease epidemiology is not fully described. This study aimed to diagnose non-scrub typhus rickettsioses including spotted fever and typhus group of Rickettsia in clinically suspected patients by using standard serological tests and recognition of common epidemiological conditions and clinical manifestations. METHODS: During the study period, a total of 700 patients of all ages with acute febrile illness were enrolled. Patients were screened for rickettsial infection using IgM Enzyme-linked immunosorbent assay (ELISA) and Immunofluorescence assay (IFA) was performed to confirm the ELISA positive results. The relevant demographic, clinical, and laboratory details of patients were documented and analyzed. RESULTS: Of 700 samples tested, 141 (20.2%) were found to be positive for IgM antibodies against rickettsioses using ELISA and IFA. SFGR was positive in 15 (2.2%), TGR was positive in 112 (16%) and 14 (2%) samples were positive for both groups. 20 (14.2%) patients required admission to the intensive care unit (ICU), and 24 (17%) in-hospital deaths occurred. CONCLUSIONS: The prevalence of rickettsioses in India appears to be underestimated; therefore, increased awareness and improved diagnostic testing could facilitate early detection of cases, pathogen-targeted appropriate treatment, and improved outcomes for patients. Despite the fact that Rickettsiae can be isolated or detected using molecular techniques in clinical specimens, serology still remains the most commonly used diagnostic method for rickettsioses around the world. Our study helps bridge the gap of limited data on Rickettsia in north India and could be useful for future epidemiological investigation of rickettsial diseases and outbreaks.


Assuntos
Infecções por Rickettsia , Rickettsia , Tifo Epidêmico Transmitido por Piolhos , Humanos , Tifo Epidêmico Transmitido por Piolhos/microbiologia , Anticorpos Antibacterianos , Infecções por Rickettsia/diagnóstico , Infecções por Rickettsia/epidemiologia , Infecções por Rickettsia/microbiologia , Imunoglobulina M
12.
Indian J Med Res ; 157(6): 549-558, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37530310

RESUMO

Background & objectives: Multidrug-resistant (MDR) Acinetobacter baumannii is a serious threat for human health worldwide. The studies on agents targeting A. baumannii are imperative due to identified A. baumannii co-infections in COVID-19. Bacteriophages are promising antibacterial agents against drug-resistant bacteria. This study intended to isolate bacteriophages against MDR A. baumannii from the water of river Ganga, to be used potentially as therapeutic and disinfectant particles. Methods: Acinetobacter phages were isolated from the Ganga water collected from Kanpur and further tested on 50 MDR A. baumannii isolates to determine host range. The phages were morphologically characterized by transmission electron microscopy. The disinfectant property of the isolated phages was tested by spraying of bacteriophage cocktail on MDR A. baumannii contaminated plastic surface, analyzed by colony-forming unit (CFU) and bioluminescence assay (adenosine triphosphate monitoring). Results: A total of seven bacteriophages were isolated against MDR A. baumannii. The bacteriophages lysed three MDR A. baumannii isolates out of 50 tested, showing narrow host range. Electron microscopy revealed hexagonal heads and long tails of bacteriophages, belonging to order Caudovirales. The bacteriophage cocktail reduced the MDR A. baumannii load efficiently on plastic surface, evidenced by reduction in CFUs and bioluminescence. Interpretation & conclusions: The findings of this study suggest that the isolated bacteriophages are potential lytic agents for MDR A. baumannii clinical isolates, and may be used as potential therapeutic agents as well as disinfectant to combat MDR A. baumannii with due consideration to phage host specificity, with further characterization.


Assuntos
Acinetobacter baumannii , Bacteriófagos , COVID-19 , Humanos , Antibacterianos/farmacologia , Microscopia Eletrônica de Transmissão , Farmacorresistência Bacteriana Múltipla
13.
Eur J Clin Microbiol Infect Dis ; 42(8): 929-943, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37171540

RESUMO

Disc diffusion testing by Kirby-Bauer technique is the most used method for determining antimicrobial susceptibility in microbiological laboratories. The current guidelines by The Clinical and Laboratory Standards Institute (CLSI) 2022 specify using an 18- to 24-h growth for testing by disc diffusion. We aim to determine if using an early growth (6 h and 10 h) would produce comparable results, thus ultimately leading to reduced turnaround time. Six-hour, 10-h, and 24-h growths of 20 quality control strains and 6-h and 24-h growths of 48 clinical samples were used to perform disc diffusion testing using a panel of appropriate antimicrobial agents. Disc diffusion zone sizes were interpreted for all and comparative analyses were performed to determine categorical agreement, minor errors (mE), major errors (ME), and very major errors (VME) according to CLSI guidelines. On comparing with the standard 24 h of incubation, disc diffusion from 6-h and 10-h growths of quality control strains showed 94.38% categorical agreement, 5.10% mE, 0.69% MEs, and no VMEs. Disc diffusion testing for the additional 40 clinical samples yielded a similarly high level of categorical agreement (98.15%) and mE, ME, and VME of 1.29%, 1.22%, and 0% respectively. Disc diffusion testing using early growth is a simple and accurate method for susceptibility testing that can reduce turnaround time and may prove to be critical for timely patient management.


Assuntos
Anti-Infecciosos , Gestão de Antimicrobianos , Humanos , Antibacterianos/farmacologia , Testes de Sensibilidade Microbiana
14.
Antimicrob Resist Infect Control ; 12(1): 36, 2023 04 18.
Artigo em Inglês | MEDLINE | ID: mdl-37072773

RESUMO

BACKGROUND: Urinary tract infection (UTI) in children is a common bacterial infection. The emergence of extended-spectrum beta-lactamases (ESBLs) poses a major challenge against the treatment of uropathogens. We aimed to characterize the E. coli isolates recovered from children with UTI for their resistance profile and circulating sequence types (ST). METHODS: Children (> 1.5-18 years of age) from different community health centres of India with symptoms of UTI were enrolled. Isolates causing significant bacteriuria were identified by Matrix-Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) and tested for antimicrobial susceptibility by the automated system, VITEK-2 (Biomeriux, Durhum, US). Nineteen E. coli isolates (15 ESBL positive and 4 ESBL negative) were sequenced in Oxford Nanopore platform followed by core-genome phylogeny, accessory genome cluster analysis, identification of sequence types, mobile genetic elements, genetic antimicrobial resistance markers. The correlation between detection of antimicrobial resistance genes with phenotypic resistance profiles was also investigated. RESULTS: Eleven percent of children had significant bacteriuria [male:female-1:1, > 50% were 11-18 years of age group]. E. coli was predominant (86%) followed by K. pneumoniae (11%). Susceptibility of E. coli was highest against fosfomycin (100%) followed by carbapenems (90.7%) and nitrofurantoin (88.8%). ST131 (15.8%) and ST167 (10.5%) found as high-risk clones with the presence of plasmid [IncFIB (63.1%), IncFIA (52.6%)], and composite transposon [Tn2680 (46.6%)] in many isolates. Few isolates coharboured multiple beta-lactamases including blaNDM-5 (33.3%), blaOXA-1 (53.3%), blaCTX-M-15 (60%) and blaTEM-4 (60%). CONCLUSIONS: This study highlights horizontal transmission of resistance genes and plasmids in paediatric patients at community centers across the nation harbouring multidrug-resistant genes such as blaNDM-5 and blaCTX-M-15 associated with high-risk clones ST131 and ST167. The data is alarming and emphasizes the need for rapid identification of resistance markers to reduce the spread in community. To our knowledge, this is the first multicentric study targeting paediatric UTI patients from the community setting of India.


Assuntos
Infecções Urinárias , Escherichia coli Uropatogênica , Humanos , Criança , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Masculino , Feminino , Escherichia coli Uropatogênica/genética , Infecções Comunitárias Adquiridas/epidemiologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Lactente , Pré-Escolar , Adolescente , Índia/epidemiologia , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Testes de Sensibilidade Microbiana , Bacteriúria/epidemiologia , Bacteriúria/microbiologia
15.
NMR Biomed ; : e4941, 2023 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-36999218

RESUMO

The diagnosis of pediatric tuberculosis (TB) remains a major challenge, hence the evaluation of new tools for improved diagnostics is urgently required. We investigated the serum metabolic profile of children with culture-confirmed intra-thoracic TB (ITTB) (n = 23) and compared it with those of non-TB controls (NTCs) (n = 13) using proton NMR spectroscopy-based targeted and untargeted metabolomics approaches. In targeted metabolic profiling, five metabolites (histidine, glycerophosphocholine, creatine/phosphocreatine, acetate, and choline) differentiated TB children from NTCs. Additionally, seven discriminatory metabolites (N-α-acetyl-lysine, polyunsaturated fatty acids, phenylalanine, lysine, lipids, glutamate + glutamine, and dimethylglycine) were identified in untargeted metabolic profiling. The pathway analysis revealed alterations in six metabolic pathways. The altered metabolites were associated with impaired protein synthesis, hindered anti-inflammatory and cytoprotective mechanisms, abnormalities in energy generation processes and membrane metabolism, and deregulated fatty acid and lipid metabolisms in children with ITTB. The diagnostic significance of the classification models obtained from significantly distinguishing metabolites showed sensitivity, specificity, and area under the curve of 78.2%, 84.6%, and 0.86, respectively, in the targeted profiling and 92.3%, 100%, and 0.99, respectively, in the untargeted profiling. Our findings highlight detectable metabolic changes in childhood ITTB; however, further validation is warranted in a large cohort of the pediatric population.

16.
PLoS One ; 18(3): e0272682, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36996065

RESUMO

BACKGROUND: The immunomodulatory effects of vitamin D are widely recognized and a few studies have been conducted to determine its utility in the treatment of tuberculosis, with mixed results. This study was conducted to see if vitamin D supplementation in patients with active pulmonary tuberculosis (PTB) in the Indian population contributed to sputum smear and culture conversion as well as the prevention of relapse. METHODS: This randomized double-blind placebo-controlled trial was conducted in three sites in India. HIV negative participants aged 15-60 years with sputum smear positive PTB were recruited according to the Revised National Tuberculosis Control Program guidelines and were randomly assigned (1:1) to receive standard anti-tubercular treatment (ATT) with either supplemental dose of oral vitamin D3 (60,000 IU/sachet weekly for first two months, fortnightly for next four months followed by monthly for the next 18 months) or placebo with same schedule. The primary outcome was relapse of PTB and secondary outcomes were time to conversion of sputum smear and sputum culture. RESULTS: A total of 846 participants were enrolled between February 1, 2017 to February 27, 2021, and randomly assigned to receive either 60,000 IU vitamin D3 (n = 424) or placebo (n = 422) along with standard ATT. Among the 697 who were cured of PTB, relapse occurred in 14 participants from the vitamin D group and 19 participants from the placebo group (hazard risk ratio 0.68, 95%CI 0.34 to 1.37, log rank p value 0.29). Similarly, no statistically significant difference was seen in time to sputum smear and sputum culture conversion between both groups. Five patients died each in vitamin D and placebo groups, but none of the deaths were attributable to the study intervention. Serum levels of vitamin D were significantly raised in the vitamin D group as compared to the placebo group, with other blood parameters not showing any significant difference between groups. CONCLUSIONS: The study reveals that vitamin D supplementation does not seem to have any beneficial effect in the treatment of PTB in terms to the prevention of relapse and time to sputum smear and culture conversion. TRIAL REGISTRATION: CTRI/2021/02/030977 (ICMR, Clinical trial registry-India).


Assuntos
Colecalciferol , Tuberculose Pulmonar , Humanos , Colecalciferol/uso terapêutico , Suplementos Nutricionais/efeitos adversos , Resultado do Tratamento , Vitamina D , Vitaminas/uso terapêutico , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/prevenção & controle , Método Duplo-Cego , Recidiva
17.
Curr HIV Res ; 21(1): 81-87, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36734902

RESUMO

BACKGROUND: It has been more than 17 years since the introduction of free ART in India. At this point, it would be prudent to look at the factors associated with the survival of persons living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLHA) who are already enrolled in the ART program. METHODS: PLHAs enrolled from antiretroviral therapy (ART) centers located in three different cities in India - Delhi, Pune and Kolkata, and were followed up at six monthly intervals monitoring the WHO stage, CD4 counts, complete blood counts, and liver and kidney function tests, for a duration of three years. RESULTS AND DISCUSSION: The incidence of mortality among HIV/AIDS patients on ART was 5.0 per 1000 patient-years (21/1410, 1.4%). Age at initiation of ART, being above 35 years, was the only significant predictor of mortality (log-rank p = 0.018). Multivariable analysis showed a significant association of an unfavourable outcome (defined as mortality or development of opportunistic infection during follow-up) with male gender (adjusted odds ratio (AOR) = 5.26, p = <0.01) and being unmarried at ART initiation (AOR = 1.39, p = 0.005). CONCLUSION: The survival of PLHA with good adherence to ART is independent of the WHO stage or CD4 counts at the initiation of ART. Initiation of ART after 35 years of age was a significant predictor of mortality.


Assuntos
Síndrome da Imunodeficiência Adquirida , Fármacos Anti-HIV , Infecções por HIV , Humanos , Masculino , Adulto , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , HIV , Índia/epidemiologia , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4
20.
BMC Infect Dis ; 22(1): 939, 2022 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-36513989

RESUMO

BACKGROUND: Indiscriminate and widespread use of antibiotics has resulted in emergence of many antibiotic-resistant organisms. Antibiotic administration during pregnancy is mostly avoided, unless there is compelling medical condition. We hypothesized that the uropathogens isolated from pregnant women would be more susceptible to antibiotics compared to those isolated from nonpregnant women, thus will be helpful in formulating separate empiric guideline for pregnant women based on the resistance pattern. METHODS: This was a prospective cross-sectional study conducted over a period of 2 years in which females with the clinical diagnosis of either cystitis or asymptomatic bacteriuria during pregnancy were included from the community settings. Uropathogen species and their antimicrobial resistance pattern were compared between the pregnant and nonpregnant groups. After accounting for centre-to-centre variation and adjusting for age and socio-economic status, the adjusted odds ratio for antibiotic resistance was calculated and compared between pregnant and nonpregnant women using logistic regression analysis. RESULTS: A total of 1758 women (pregnant: 43.3%; nonpregnant: 56.6%) were screened in the study over a period of 2 years, out of which 9.3% (163/1758) were having significant bacteriuria. Escherichia coli and Klebsiella pneumoniae were the two commonest uropathogen in both the groups; their prevalence being 83.6% in pregnant women and 85.2% in nonpregnant women, respectively. Resistance against ampicillin, cefixime, cefoxitin, ceftazidime, ceftriaxone and amoxicillin-clavulanic acid were found significantly lower in the pregnant women compared to nonpregnant. After adjusting the age and socio-economic status accounting for centre-to-centre variation, the odds of resistance for cefixime, amoxicillin-clavulanic acid and co-trimoxazole were found lower and statistically significant among the pregnant women group. CONCLUSIONS: The antimicrobial resistance was significantly higher among the community-dwelling nonpregnant women compared to pregnant women in case of few antibiotics. The study highlighted the need of building local antibiogram that could help to initiate the empirical treatment and thus prevent emergence of antimicrobial resistance.


Assuntos
Gestão de Antimicrobianos , Bacteriúria , Infecções Urinárias , Feminino , Humanos , Gravidez , Bacteriúria/diagnóstico , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Cefixima/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia , Estudos Transversais , Estudos Prospectivos , Vida Independente , Resistência Microbiana a Medicamentos , Testes de Sensibilidade Microbiana , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Escherichia coli
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