Gram-negative bacteria (GNB) are known to undergo morphological changes like elongation, abrupt bulge formation at the site of potential cell division and bulge stagnation following exposure to β-lactam antibiotics. Positive blood cultures of a 78-year-old man on Gram staining showed a long filamentous GNB with spherical enlargement along some bacterial filaments. Cultures on solid media grew pan sensitive K. pneumoniae of normal morphology. A total of 16 cases of GNB showing filamentous or spheroplast forms have been reported in literature. Clinicians and microbiologists should be aware of potential Gram stain biases when analysing clinical samples taken under prolonged antibacterial treatment.
{"title":"Filamentous forms of Gram-negative bacteria on microscopy: Report of a case and review of literature","authors":"Anil Kumar , Chinnu Liz Sebastian , Vivek Vinod , Liyona Varghese , Anjana Venugopal , Lalitha Biswas , Rajesh Gopalakrishna , Raja Biswas","doi":"10.1016/j.ijmmb.2025.100864","DOIUrl":"10.1016/j.ijmmb.2025.100864","url":null,"abstract":"<div><div>Gram-negative bacteria (GNB) are known to undergo morphological changes like elongation, abrupt bulge formation at the site of potential cell division and bulge stagnation following exposure to β-lactam antibiotics. Positive blood cultures of a 78-year-old man on Gram staining showed a long filamentous GNB with spherical enlargement along some bacterial filaments. Cultures on solid media grew pan sensitive <em>K. pneumoniae</em> of normal morphology<em>.</em> A total of 16 cases of GNB showing filamentous or spheroplast forms have been reported in literature. Clinicians and microbiologists should be aware of potential Gram stain biases when analysing clinical samples taken under prolonged antibacterial treatment.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100864"},"PeriodicalIF":1.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Blepharitis is a common ocular disease, characterized by redness and itchy eyelid margin. Demodex ectoparasite mite infestation is an underreported cause of blepharitis in urban setting. Purpose of this study was to estimate proportion of individuals with blepharitis showing evidence of Demodex mite infestation. Overall, 20 individuals with blepharitis and collarettes showed presence of Demodex mite on light microscopy. The study emphasizes the importance of light microscopic examination of epilated eyelash for timely diagnosis of Demodex infestation.
{"title":"Demodex mite blepharitis; Look for the mite you might have","authors":"Pooja Naharia , Pradeep Kumar , Puneet Bhatt , Shailaza Tripathi , Prashant Jindamwar , Santosh Karade , Sanjay Kumar Mishra","doi":"10.1016/j.ijmmb.2025.100861","DOIUrl":"10.1016/j.ijmmb.2025.100861","url":null,"abstract":"<div><div>Blepharitis is a common ocular disease, characterized by redness and itchy eyelid margin. <em>Demodex</em> ectoparasite mite infestation is an underreported cause of blepharitis in urban setting. Purpose of this study was to estimate proportion of individuals with blepharitis showing evidence of <em>Demodex</em> mite infestation. Overall, 20 individuals with blepharitis and collarettes showed presence of Demodex mite on light microscopy. The study emphasizes the importance of light microscopic examination of epilated eyelash for timely diagnosis of <em>Demodex</em> infestation.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100861"},"PeriodicalIF":1.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fosfomycin is a therapeutic alternative for urinary tract infection (UTI). Escherichia coli produces fosfomycin modifying enzymes (fos genes) that is the contributor for resistance to this group of antimicrobials. The current research work characterizes fosfomycin resistance determinants in Escherichia coli and their transferability. Fosfomycin modifying enzyme genes were found to be carried within a plasmid of inc type FIC. Under subinhibitory concentration of fosfomycin, transcriptional expression revealed upregulation for fosA10, fosA8, fosA, and fosA2.The current study emphasizes the necessity of ongoing surveillance of E. coli resistance patterns and transmission dynamics, particularly regards to fosfomycin, to implement the best possible treatment strategy.
{"title":"Transcriptional expression analysis of fosfomycin resistance determinants in Escherichia coli with MDR trait","authors":"Jayalaxmi Wangkheimayum , Ng Lakhitombi Chanu , Debadatta Dhar Chanda , Amitabha Bhattacharjee","doi":"10.1016/j.ijmmb.2025.100859","DOIUrl":"10.1016/j.ijmmb.2025.100859","url":null,"abstract":"<div><div>Fosfomycin is a therapeutic alternative for urinary tract infection (UTI). <em>Escherichia coli</em> produces fosfomycin modifying enzymes (<em>fos</em> genes) that is the contributor for resistance to this group of antimicrobials. The current research work characterizes fosfomycin resistance determinants in <em>Escherichia coli</em> and their transferability. Fosfomycin modifying enzyme genes were found to be carried within a plasmid of inc type FIC. Under subinhibitory concentration of fosfomycin, transcriptional expression revealed upregulation for <em>fosA10, fosA8, fosA</em>, and <em>fosA2</em>.The current study emphasizes the necessity of ongoing surveillance of <em>E. coli</em> resistance patterns and transmission dynamics, particularly regards to fosfomycin, to implement the best possible treatment strategy.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100859"},"PeriodicalIF":1.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-17DOI: 10.1016/j.ijmmb.2025.100856
T Jacob John
{"title":"Microbiology: Foundational science of modern medicine","authors":"T Jacob John","doi":"10.1016/j.ijmmb.2025.100856","DOIUrl":"10.1016/j.ijmmb.2025.100856","url":null,"abstract":"","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100856"},"PeriodicalIF":1.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-17DOI: 10.1016/j.ijmmb.2025.100854
T. Jacob John , Rajeev Zachariah Kompithra
The Universal Immunization Program (UIP) is the cornerstone of India's disease prevention endeavour, aimed at protecting children and pregnant women from Vaccine-Preventable Diseases (VPDs). The Expanded Program on Immunization (EPI) was designed and launched by the World Health Organisation (WHO) in 1974, with BCG, OPV, DPT and Measles Vaccine (MV) in children and Tetanus Toxoid in pregnant women, all given free of cost. India adopted EPI in 1978 without MV. MV was rolled out nationally during 1985–1990 following which EPI was re-named Universal Immunisation Programme (UIP). In 2000 the National Technical Advisory Group on Immunisation (NTAGI) was established and under its recommendations, newer vaccines have been systematically included in UIP. India introduced targeted immunization drives, and digital platforms for vaccine logistics management. This paper reviews UIP's major achievements, discusses emerging concerns, and proposes ways forward to address these gaps.
{"title":"India's universal immunization program: A review of successes, challenges, and future directions","authors":"T. Jacob John , Rajeev Zachariah Kompithra","doi":"10.1016/j.ijmmb.2025.100854","DOIUrl":"10.1016/j.ijmmb.2025.100854","url":null,"abstract":"<div><div>The Universal Immunization Program (UIP) is the cornerstone of India's disease prevention endeavour, aimed at protecting children and pregnant women from Vaccine-Preventable Diseases (VPDs). The Expanded Program on Immunization (EPI) was designed and launched by the World Health Organisation (WHO) in 1974, with BCG, OPV, DPT and Measles Vaccine (MV) in children and Tetanus Toxoid in pregnant women, all given free of cost. India adopted EPI in 1978 without MV. MV was rolled out nationally during 1985–1990 following which EPI was re-named Universal Immunisation Programme (UIP). In 2000 the National Technical Advisory Group on Immunisation (NTAGI) was established and under its recommendations, newer vaccines have been systematically included in UIP. India introduced targeted immunization drives, and digital platforms for vaccine logistics management. This paper reviews UIP's major achievements, discusses emerging concerns, and proposes ways forward to address these gaps.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100854"},"PeriodicalIF":1.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-17DOI: 10.1016/j.ijmmb.2025.100855
Vijay Moses , Joel B , Rani D. Sahni , Binesh Lal , Jacob John , Venkata Raghava , Indranil Biswas , Nisha Dhar
Background
Group A Streptococcus (GAS) is a significant pathogen responsible for a wide range of diseases, including severe complications such as Rheumatic Heart Disease (RHD), which predominantly affect low- and middle-income countries (LMICs) like India. GAS infections impact over 800 million individuals annually, resulting in approximately 639,000 deaths due to RHD complications. Despite significant advancements, developing an effective GAS vaccine has faced several challenges, including the complexity of GAS virulence mechanisms, the diversity of emm types, and the lack of suitable preclinical models. Recent vaccine research has focused on both M protein-based and non-M protein-based vaccines, with several candidates showing promising results. However, current vaccines only address 50 % of the prevalent emm types in India, highlighting the need for further research and development.
Objective
This review aims to examine the historical and current progress in GAS vaccine development, identify key challenges, and explore future strategies, with a focus on the Indian public health context.
Content
A comprehensive review of existing literature on GAS and its complications was conducted, focusing on the global and Indian burden of GAS infections, the resurgence of scarlet fever, and the emergence of virulent strains such as M1UK. The study also reviewed recent global initiatives like the Cairo Accord and the 71st World Health Assembly's resolution on RHD to emphasize the need for international collaboration in vaccine development. Continued global cooperation, intensified research efforts, and targeted public health initiatives are essential for overcoming the challenges in GAS vaccine development. Advocacy and investment in this area are crucial for reducing the global burden of GAS infections and their associated complications. This study aims to provide comprehensive genomic data on GAS isolates from India, enabling comparisons with global findings, highlighting regional differences, and contributing to a more comprehensive understanding of GAS epidemiology and pathogenicity.
背景A族链球菌（GAS）是导致多种疾病的重要病原体，包括风湿性心脏病（RHD）等严重并发症，主要影响印度等中低收入国家。每年受 GAS 感染的人数超过 8 亿，约有 63.9 万人死于风湿性心脏病并发症。尽管取得了重大进展，但开发有效的 GAS 疫苗仍面临着一些挑战，包括 GAS 毒力机制的复杂性、emm 类型的多样性以及缺乏合适的临床前模型。近期的疫苗研究主要集中在基于 M 蛋白和非 M 蛋白的疫苗上，一些候选疫苗显示出了良好的效果。本综述旨在研究 GAS 疫苗开发的历史和当前进展，确定主要挑战，并探讨未来战略，重点关注印度的公共卫生背景。内容 对有关 GAS 及其并发症的现有文献进行了全面综述，重点关注全球和印度的 GAS 感染负担、猩红热复发以及 M1UK 等毒株的出现。研究还回顾了近期的全球倡议，如《开罗协议》和第 71 届世界卫生大会关于流脑的决议，以强调在疫苗开发方面开展国际合作的必要性。持续的全球合作、强化的研究工作和有针对性的公共卫生倡议对于克服 GAS 疫苗开发方面的挑战至关重要。在这一领域的宣传和投资对于减轻全球 GAS 感染及其相关并发症的负担至关重要。本研究旨在提供印度 GAS 分离物的全面基因组数据，以便与全球研究结果进行比较，突出地区差异，并有助于更全面地了解 GAS 的流行病学和致病性。
{"title":"Group A Streptococcus vaccine Development: An Indian public health imperative","authors":"Vijay Moses , Joel B , Rani D. Sahni , Binesh Lal , Jacob John , Venkata Raghava , Indranil Biswas , Nisha Dhar","doi":"10.1016/j.ijmmb.2025.100855","DOIUrl":"10.1016/j.ijmmb.2025.100855","url":null,"abstract":"<div><h3>Background</h3><div>Group A <em>Streptococcus</em> (GAS) is a significant pathogen responsible for a wide range of diseases, including severe complications such as Rheumatic Heart Disease (RHD), which predominantly affect low- and middle-income countries (LMICs) like India. GAS infections impact over 800 million individuals annually, resulting in approximately 639,000 deaths due to RHD complications. Despite significant advancements, developing an effective GAS vaccine has faced several challenges, including the complexity of GAS virulence mechanisms, the diversity of <em>emm</em> types, and the lack of suitable preclinical models. Recent vaccine research has focused on both M protein-based and non-M protein-based vaccines, with several candidates showing promising results. However, current vaccines only address 50 % of the prevalent <em>emm</em> types in India, highlighting the need for further research and development.</div></div><div><h3>Objective</h3><div>This review aims to examine the historical and current progress in GAS vaccine development, identify key challenges, and explore future strategies, with a focus on the Indian public health context.</div></div><div><h3>Content</h3><div>A comprehensive review of existing literature on GAS and its complications was conducted, focusing on the global and Indian burden of GAS infections, the resurgence of scarlet fever, and the emergence of virulent strains such as M1UK. The study also reviewed recent global initiatives like the Cairo Accord and the 71st World Health Assembly's resolution on RHD to emphasize the need for international collaboration in vaccine development. Continued global cooperation, intensified research efforts, and targeted public health initiatives are essential for overcoming the challenges in GAS vaccine development. Advocacy and investment in this area are crucial for reducing the global burden of GAS infections and their associated complications. This study aims to provide comprehensive genomic data on GAS isolates from India, enabling comparisons with global findings, highlighting regional differences, and contributing to a more comprehensive understanding of GAS epidemiology and pathogenicity.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100855"},"PeriodicalIF":1.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dengue is a common arboviral disease of tropical and sub-tropical regions of the globe with high prevalence rate in South-East Asian region. Association of viral load with dengue disease severity is dependent on various factors like dengue serotype, primary or secondary infection and immune response of an individual. The objective of the study was to evaluate the association of dengue viral load with dengue disease severity like dengue fever (DF), dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS), dengue serotypes and different clinical manifestations detected during dengue like thrombocytopenia, leukopenia and increased liver enzymes.
Materials and methods
The systematic review and meta-analysis [PROSPERO (CRD42024601682)] is prepared by abiding to PRISMA checklist. It includes twenty-nine observational cross-sectional studies, which has compared association of dengue viral load with dengue disease severity, dengue serotypes and different clinical manifestations in dengue patients.
Result
A total of 3983 dengue patients were included in the studies out of which 1758 were diagnosed with DF and 2225 were diagnosed with DHF/DSS. Most of the studies were from South-East Asian countries followed by America and Europe. Meta-analysis of the studies revealed that, high viral load was mostly detected in DHF/DSS as compared to DF. Regarding co-relation of viral load, chances of high viral load was more in female patients than male patients. On comparing viral load with different clinical manifestations, it was seen that, the odds of high viral load were more in patients diagnosed with thrombocytopenia and leukopenia, whereas the odds of high viral load were lower in patients diagnosed with increased secretion of liver enzymes.
Conclusion
High Viral load had significant association with dengue disease severity. Female patients had high viral load as compared to male patients. Therefore, viral load may be regarded a potential prognostic tool in detecting dengue severity in patients, and studies need to be conducted with sufficient sample size, abiding to a single classification system and measure of outcome to prevent heterogeneity.
{"title":"Concordance of dengue viral load with disease severity and different clinical manifestations: A systematic review and meta-analysis","authors":"Diksha Mohapatra , Baijayantimala Mishra , Prabhudutta Mamidi , Sailendra Panda","doi":"10.1016/j.ijmmb.2025.100852","DOIUrl":"10.1016/j.ijmmb.2025.100852","url":null,"abstract":"<div><h3>Introduction</h3><div>Dengue is a common arboviral disease of tropical and sub-tropical regions of the globe with high prevalence rate in South-East Asian region. Association of viral load with dengue disease severity is dependent on various factors like dengue serotype, primary or secondary infection and immune response of an individual. The objective of the study was to evaluate the association of dengue viral load with dengue disease severity like dengue fever (DF), dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS), dengue serotypes and different clinical manifestations detected during dengue like thrombocytopenia, leukopenia and increased liver enzymes.</div></div><div><h3>Materials and methods</h3><div>The systematic review and meta-analysis [PROSPERO (CRD42024601682)] is prepared by abiding to PRISMA checklist. It includes twenty-nine observational cross-sectional studies, which has compared association of dengue viral load with dengue disease severity, dengue serotypes and different clinical manifestations in dengue patients.</div></div><div><h3>Result</h3><div>A total of 3983 dengue patients were included in the studies out of which 1758 were diagnosed with DF and 2225 were diagnosed with DHF/DSS. Most of the studies were from South-East Asian countries followed by America and Europe. Meta-analysis of the studies revealed that, high viral load was mostly detected in DHF/DSS as compared to DF. Regarding co-relation of viral load, chances of high viral load was more in female patients than male patients. On comparing viral load with different clinical manifestations, it was seen that, the odds of high viral load were more in patients diagnosed with thrombocytopenia and leukopenia, whereas the odds of high viral load were lower in patients diagnosed with increased secretion of liver enzymes.</div></div><div><h3>Conclusion</h3><div>High Viral load had significant association with dengue disease severity. Female patients had high viral load as compared to male patients. Therefore, viral load may be regarded a potential prognostic tool in detecting dengue severity in patients, and studies need to be conducted with sufficient sample size, abiding to a single classification system and measure of outcome to prevent heterogeneity.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100852"},"PeriodicalIF":1.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The dissemination of Klebsiella pneumoniae is becoming a major concern, as this organism is responsible for a significant proportion of hospital acquired infections. Due to complexity of this organism adequate knowledge on the epidemiology and infection control practices associated with the dissemination is highly required. Therefore, this study designed to include consecutive samples from environment and patients to assess the similarity pattern among isolates from different sources.
Methodology
We included patients with hospital acquired infections with K. pneumonaie and environment isolates. To obtain the complete sequence forty-eight isolates were sequenced on Illumina MiSeq 250 2 × 250 bp paired end (Illumina, USA) and Nanopore (Oxford). These includes 30 BSI cases, 13 environment and 5 from water. Assembly of good quality reads were prepared using Unicycler. AMR gene detection was done using Resfinder of Abricate and sequence similarity was observed by SNP based phylogenetic analysis.
Results
The most common sequence type of organism among all was ST 231 and ST 395. ST 29 was common between water and clinical isolates. Average (range) number of AMR genes present in clinical isolates were 16 (3–24). The antimicrobial genes belong to 41 classes and fosA was highly prevalent. The frequency of blaNDM was present 55.4 % (27/48) and blaOXA in 61.6 % (30/48). The strain ST 395 and ST 16 carried highest no. of replicons n = 10 and n = 9. The predominant plasmid replicon Col440I (N = 58) followed by IncFII_1_pKP91 (N = 34) and ColRNAI (N = 29). The phylogenetic analysis showed high similarity between clinical and environmental samples.
Conclusion
This study concludes that environment play essential role in disseminating the infectious strains of organism resulting in increased rates of hospital acquired infections. Therefore, there is an imperative necessity for implementing infection control practices to prevent the spread of infectious diseases.
{"title":"Transmission dynamics of multidrug resistant Klebsiella pneumoniae from an Indian hospital","authors":"Mamta Puraswani , Ashita Ashita , Neha Kumari Ambashta , Richa Aggrawal , Kapil Dev Soni , Subodh Kumar , Sushma Sagar , Amit Gupta , Kamran Farooque , Purva Mathur","doi":"10.1016/j.ijmmb.2025.100848","DOIUrl":"10.1016/j.ijmmb.2025.100848","url":null,"abstract":"<div><h3>Object</h3><div>The dissemination of <em>Klebsiella pneumoniae</em> is becoming a major concern, as this organism is responsible for a significant proportion of hospital acquired infections. Due to complexity of this organism adequate knowledge on the epidemiology and infection control practices associated with the dissemination is highly required. Therefore, this study designed to include consecutive samples from environment and patients to assess the similarity pattern among isolates from different sources.</div></div><div><h3>Methodology</h3><div>We included patients with hospital acquired infections with <em>K. pneumonaie</em> and environment isolates. To obtain the complete sequence forty-eight isolates were sequenced on Illumina MiSeq 250 2 × 250 bp paired end (Illumina, USA) and Nanopore (Oxford). These includes 30 BSI cases, 13 environment and 5 from water. Assembly of good quality reads were prepared using Unicycler. AMR gene detection was done using Resfinder of Abricate and sequence similarity was observed by SNP based phylogenetic analysis.</div></div><div><h3>Results</h3><div>The most common sequence type of organism among all was ST 231 and ST 395. ST 29 was common between water and clinical isolates. Average (range) number of AMR genes present in clinical isolates were 16 (3–24). The antimicrobial genes belong to 41 classes and fosA was highly prevalent. The frequency of <em>blaNDM</em> was present 55.4 % (27/48) and <em>blaOXA</em> in 61.6 % (30/48). The strain ST 395 and ST 16 carried highest no. of replicons n = 10 and n = 9. The predominant plasmid replicon Col440I (N = 58) followed by IncFII_1_pKP91 (N = 34) and ColRNAI (N = 29). The phylogenetic analysis showed high similarity between clinical and environmental samples.</div></div><div><h3>Conclusion</h3><div>This study concludes that environment play essential role in disseminating the infectious strains of organism resulting in increased rates of hospital acquired infections. Therefore, there is an imperative necessity for implementing infection control practices to prevent the spread of infectious diseases.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100848"},"PeriodicalIF":1.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-10DOI: 10.1016/j.ijmmb.2025.100846
Madhumathi Irulappan , Jobin John Jacob , Jayaprakasam Madhumathi , S. Lydia Jennifer , Vedhagiri Kumaresan , Rajesh Kumar , Balaji Veeraraghavan , Lucky Sangal , Sangeetha Nithiyanandam , Ankur Mutreja
Background
Pertussis, once controlled by whole-cell pertussis (wP) vaccines, has resurged due to the shift to acellular pertussis (aP) vaccines, waning immunity, antigenic variation, and macrolide resistant Bordetella pertussis strains. Despite high DTwP coverage, India continues to face a significant burden and this review synthesizes current knowledge and advocates for enhanced surveillance, updated vaccination strategies, and targeted interventions to reduce the clinical and public health impact of pertussis.
Methods
Epidemiological data, genetic studies, and immunological insights from global and Indian contexts were reviewed. Information was obtained from PubMed, MEDLINE, Google Scholar, and WHONET. Particular attention was given to genomic surveillance, vaccine-induced antigenic shifts, and real-world outcomes of DTwP and aP vaccines.
Results
Despite high DTwP vaccine coverage, India accounts for 26.5 % of global pertussis cases, driven by waning immunity, low booster uptake, and the spread of vaccine-escaped ptxP3 strains. The emergence of macrolide resistance further challenges disease control, with selective pressures influencing genetic shifts in B. pertussis. While wP vaccines provide long-lasting immunity, aP vaccines offer shorter protection and induce linked-epitope suppression, contributing to the resurgence of pertussis.
Conclusion
There is an urgent need for Tdap booster programs in adolescents and adults to address waning immunity and evolving strains. Strengthened genomic and immunological surveillance, alongside innovative vaccine formulations and delivery systems, are critical forsustainable pertussis control in India.
{"title":"Pertussis in India: Vaccine-driven evolution, waning immunity, and the urgent need for Tdap boosters","authors":"Madhumathi Irulappan , Jobin John Jacob , Jayaprakasam Madhumathi , S. Lydia Jennifer , Vedhagiri Kumaresan , Rajesh Kumar , Balaji Veeraraghavan , Lucky Sangal , Sangeetha Nithiyanandam , Ankur Mutreja","doi":"10.1016/j.ijmmb.2025.100846","DOIUrl":"10.1016/j.ijmmb.2025.100846","url":null,"abstract":"<div><h3>Background</h3><div>Pertussis, once controlled by whole-cell pertussis (wP) vaccines, has resurged due to the shift to acellular pertussis (aP) vaccines, waning immunity, antigenic variation, and macrolide resistant Bordetella pertussis strains. Despite high DTwP coverage, India continues to face a significant burden and this review synthesizes current knowledge and advocates for enhanced surveillance, updated vaccination strategies, and targeted interventions to reduce the clinical and public health impact of pertussis.</div></div><div><h3>Methods</h3><div>Epidemiological data, genetic studies, and immunological insights from global and Indian contexts were reviewed. Information was obtained from PubMed, MEDLINE, Google Scholar, and WHONET. Particular attention was given to genomic surveillance, vaccine-induced antigenic shifts, and real-world outcomes of DTwP and aP vaccines.</div></div><div><h3>Results</h3><div>Despite high DTwP vaccine coverage, India accounts for 26.5 % of global pertussis cases, driven by waning immunity, low booster uptake, and the spread of vaccine-escaped <em>ptxP3</em> strains. The emergence of macrolide resistance further challenges disease control, with selective pressures influencing genetic shifts in <em>B. pertussis</em>. While wP vaccines provide long-lasting immunity, aP vaccines offer shorter protection and induce linked-epitope suppression, contributing to the resurgence of pertussis.</div></div><div><h3>Conclusion</h3><div>There is an urgent need for Tdap booster programs in adolescents and adults to address waning immunity and evolving strains. Strengthened genomic and immunological surveillance, alongside innovative vaccine formulations and delivery systems, are critical forsustainable pertussis control in India.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100846"},"PeriodicalIF":1.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-10DOI: 10.1016/j.ijmmb.2025.100847
John Dickson Calvin Devadasan , Karthick Nithyanandhan , Gnanadurai John Fletcher, Rajesh Kannangai, Priya Abraham
Introduction
Human papillomaviruses (HPV) cause almost all cervical cancer cases globally, with the high-risk genotypes 16/18 causing at least 70 % of cancers, of which most cases occur in low-to-middle-income countries. Prophylactic vaccination plays a major role in the prevention of cervical cancer, which could effectively prevent the incidence of HPV infection. The L1 protein, which, when assembled into virus-like particles, induces HPV-type-specific neutralizing antibodies, which form the basis of all currently licensed HPV vaccines. There are six approved prophylactic HPV vaccines. All these vaccines are designed to prevent HPV 16 and 18-associated cervical precancers, thereby preventing approximately 70 % of the cancers. This review looks at the current HPV prophylactic vaccines, their mechanism of action, vaccination schedules, and the cost of different vaccines.
{"title":"HPV vaccines – A game changer for preventing HPV-related cancers","authors":"John Dickson Calvin Devadasan , Karthick Nithyanandhan , Gnanadurai John Fletcher, Rajesh Kannangai, Priya Abraham","doi":"10.1016/j.ijmmb.2025.100847","DOIUrl":"10.1016/j.ijmmb.2025.100847","url":null,"abstract":"<div><h3>Introduction</h3><div>Human papillomaviruses (HPV) cause almost all cervical cancer cases globally, with the high-risk genotypes 16/18 causing at least 70 % of cancers, of which most cases occur in low-to-middle-income countries. Prophylactic vaccination plays a major role in the prevention of cervical cancer, which could effectively prevent the incidence of HPV infection. The L1 protein, which, when assembled into virus-like particles, induces HPV-type-specific neutralizing antibodies, which form the basis of all currently licensed HPV vaccines. There are six approved prophylactic HPV vaccines. All these vaccines are designed to prevent HPV 16 and 18-associated cervical precancers, thereby preventing approximately 70 % of the cancers. This review looks at the current HPV prophylactic vaccines, their mechanism of action, vaccination schedules, and the cost of different vaccines.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100847"},"PeriodicalIF":1.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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