Multidrug-resistant Vibrio cholerae O1 in Belgaum, south India.

An outbreak of acute diarrhoea occurred in the Belgundi area (population 3896) of Belgaum Taluka (population 815 581) in Karnataka, South India, in June 2010. An estimated 16.22 % of people were affected and 0.16 % deaths were reported. Vibrio cholerae O1 El Tor was isolated from 18 of the 147 stool samples cultured. Seven out of eight drinking water samples collected from different sources were found to be grossly contaminated with faecal coliforms. All isolates were multidrug resistant, with some showing resistance to quinolones, gentamicin and cephalosporins in addition to co-trimoxazole and tetracycline, the drugs that were being used by the state health authorities for empirical treatment. Two serotypes and at least eight genotypes of V. cholerae were observed among the isolates. Cholera was confirmed as one, if not the only, cause of the outbreak, which, to our belief, is the first report of cholera from this region. It might have occurred due to a 'flare up' in the number of endemic strains triggered by shortage of portable water, onset of monsoon rains and breakdown of sanitation systems, rather than being a de novo outbreak arising out of new exogenous infectious sources. A change in the empirical treatment, coupled with chlorination, improvement in sanitation measures and extensive Information Education Communication activities, resulted in decline of the outbreak and prevention of further deaths.

A fatal case of empyema thoracis by Nocardia farcinica in an immunocompromised patient.

Empyema thoracis by Nocardia farcinica infection is uncommon. Here we report a rare and fatal infection in a 27-year-old HIV- seropositive male who presented with cough, expectoration, and breathlessness. Nocardia farcinica was isolated from sputum and pus from the pleural cavity. Confirmation of the isolate and minimum inhibitory concentrations (MIC) for various antibiotics was done at the Aerobic Actinomycetes Reference Laboratory, Centres for Disease Control and Prevention (CDC), Atlanta. Patient was treated with suitable antibiotics and antiretroviral drugs in spite of which he eventually succumbed to the disease.

Meningitis due to Rhodotorula glutinis in an HIV infected patient.

Rhodotorula spp, though considered a common saprophyte, recently has been reported as causative agent of opportunistic mycoses. We present a case of meningitis in an immunocompromised human immunodeficiency virus infected patient who presented with longstanding fever. He was diagnosed as a case of chronic meningitis. Diagnosis was confirmed by cell cytology, India ink preparation, Gram staining and culture of cerebrospinal fluid (CSF) sample. CSF culture grew Rhodotorula glutinis. Therapy with amphotericin B was successful in eliminating the yeast from CSF and the patient was discharged after recovery.

Biofilm inhibition and antimicrobial activity of a dentifrice containing salivary substitutes.

BACKGROUND/AIMS: A healthy mouth harbours the continuous combined action of a salivary defence system with that of a salivary peroxidase system, containing lactoferrin, lysozyme, immunoglobulin and growth factors. This system maintains neutral pH and creates an oral environment where harmful bacteria are inhibited, thus preventing the formation of biofilms. The objective of this clinico-microbiological trial was to evaluate the anti-plaque effect of a dentifrice containing salivary substitutes, compared with a placebo-control dentifrice and to assess the effect of dentifrice on oral bacterial count. METHODS: The design was a randomized controlled, double-blind, parallel study comparing a placebo-dentifrice to a dentifrice formulation containing salivary substitutes. Toothpaste slurry rinses were used over a 96-h period by 20 volunteers who refrained from all other oral hygiene procedures. Commercially available fluoride toothpaste was used as control. Plaque was scored and unstimulated salivary samples were collected at day 0 and after 4 days. A microbiological analysis was carried out for the salivary samples. Data were analyzed by using Student's t-tests. RESULTS: There was a statistically significant mean difference in plaque scores after using test paste (1.19 + 0.31) in comparison with those using placebo toothpaste (1.95 + 0.33). The difference between mean increase in colony forming units for the test and the placebo group was (25.2 + 8) x 10(5) and (17.5 + 6.01) x 10(5), respectively, which was statistically significant. CONCLUSIONS: The findings of the study support the hypothesis that toothpaste containing salivary substitutes prevents dental biofilm formation and exhibits antimicrobial property when compared with a placebo dentifrice.