Pub Date : 2025-02-25DOI: 10.1016/j.ijmmb.2025.100810
Vijayan Priya, S. Nagarathna, Kumari HB. Veena
Background
Methicillin-resistant Staphylococcus aureus (MRSA) continues to be a significant cause of healthcare-associated infections (HAIs). In this study, we aimed to characterize the MRSA isolates obtained from HAIs.
Methods
A total of 200 clinical and 13 nasal MRSA isolates were collected and tested. The samples were analyzed for SCCmec typing by using multiplex PCR. Microtiter for biofilm formation were performed and molecular typing for the samples were performed for spa and agr typing.
Results
The isolates showed 100 % sensitivity to vancomycin and linezolid, while 92.5 % were multidrug-resistant. Strong biofilm-forming ability was observed in 47 % of the isolates. SCC mec typing identified 52.5 % of the isolates as classical hospital-associated MRSA or HA-MRSA (SCC mec type III), 23.5 % as community-associated MRSA or CA-MRSA (type IV and V), and 16.5 % as non-typeable, with 7.5 % having multiple SCCmec types.
Conclusion
Comparison of HA and CA-MRSA traits revealed that both groups had multidrug resistance, but HA-MRSA was distinguished by its strong capacity for biofilm formation, whereas CA-MRSA was marked by a high count of toxin gene. Our study, to the best of our awareness, documents the presence of LA-MRSA (SCCmec V- t127-agr III) causing HAIs in Indian patients for the first time.
{"title":"Molecular characterization of methicillin-resistant Staphylococcus aureus: Dissemination of multidrug-resistant community-associated MRSA and emergence of LA-MRSA, in a healthcare setting","authors":"Vijayan Priya, S. Nagarathna, Kumari HB. Veena","doi":"10.1016/j.ijmmb.2025.100810","DOIUrl":"10.1016/j.ijmmb.2025.100810","url":null,"abstract":"<div><h3>Background</h3><div>Methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) continues to be a significant cause of healthcare-associated infections (HAIs). In this study, we aimed to characterize the MRSA isolates obtained from HAIs.</div></div><div><h3>Methods</h3><div>A total of 200 clinical and 13 nasal MRSA isolates were collected and tested. The samples were analyzed for SCC<em>mec</em> typing by using multiplex PCR. Microtiter for biofilm formation were performed and molecular typing for the samples were performed for spa and agr typing.</div></div><div><h3>Results</h3><div>The isolates showed 100 % sensitivity to vancomycin and linezolid, while 92.5 % were multidrug-resistant. Strong biofilm-forming ability was observed in 47 % of the isolates. SCC mec typing identified 52.5 % of the isolates as classical hospital-associated MRSA or HA-MRSA (SCC mec type III), 23.5 % as community-associated MRSA or CA-MRSA (type IV and V), and 16.5 % as non-typeable, with 7.5 % having multiple SCCmec types.</div></div><div><h3>Conclusion</h3><div>Comparison of HA and CA-MRSA traits revealed that both groups had multidrug resistance, but HA-MRSA was distinguished by its strong capacity for biofilm formation, whereas CA-MRSA was marked by a high count of toxin gene. Our study, to the best of our awareness, documents the presence of LA-MRSA (SCCmec V- t127-agr III) causing HAIs in Indian patients for the first time.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"54 ","pages":"Article 100810"},"PeriodicalIF":1.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457869","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 : 2025-02-25DOI: 10.1016/j.ijmmb.2025.100809
Prerna S. Salian , Dhruti Sheth , Anurag K. Bari , Aruna Poojary , Seema Rohra , Minipriyaa R
Background
Sepsis requires prompt diagnosis for effective management. Standard Antimicrobial Susceptibility Testing (AST) is time-consuming, highlighting the need for Rapid Antimicrobial Susceptibility Testing (RAST) to provide reports earlier.
Purpose
To compare the results of RAST and AST in order to determine the feasibility and reliability of RAST.
Materials and methods
A study at a tertiary care facility analyzed 95 positive blood culture isolates. RAST was performed by Disk Diffusion (DD) and VITEK 2 Compact Automated Broth Microdilution (BMD) from flagged positive broth. In contrast, AST was performed by DD and BMD from isolated colonies.
Results
Among 95 Gram-negative bacteria (GNB), E. coli (n = 40), and K. pneumoniae (n = 19) were most common. RAST vs AST DD for GNB showed 91 % Categorical agreement (CA) with an overall Very Major Error (VME) and Major Error (ME) rates of 0.7 % & 2.2 % and respectively. For GNB, RAST vs. AST BMD demonstrated a CA of 97 % and Essential Agreement (EA) of 97.7 %, with VME and ME rates of 1.7 % (excluding E.coli + Cefepime drug bug pairs) and 0.1 % respectively.
Conclusion
These findings suggest that RAST is a reliable antimicrobial susceptibility tool for GNB from direct Blood Culture broths. RAST can support early initiation of targeted antimicrobial therapy in patients with sepsis.
{"title":"Comparison of rapid antimicrobial susceptibility testing of flash positive blood culture bottles using disk diffusion and automated broth microdilution on VITEK 2 compact with standard methods: Clinical Laboratory Standards Institute (CLSI) protocol","authors":"Prerna S. Salian , Dhruti Sheth , Anurag K. Bari , Aruna Poojary , Seema Rohra , Minipriyaa R","doi":"10.1016/j.ijmmb.2025.100809","DOIUrl":"10.1016/j.ijmmb.2025.100809","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis requires prompt diagnosis for effective management. Standard Antimicrobial Susceptibility Testing (AST) is time-consuming, highlighting the need for Rapid Antimicrobial Susceptibility Testing (RAST) to provide reports earlier.</div></div><div><h3>Purpose</h3><div>To compare the results of RAST and AST in order to determine the feasibility and reliability of RAST.</div></div><div><h3>Materials and methods</h3><div>A study at a tertiary care facility analyzed 95 positive blood culture isolates. RAST was performed by Disk Diffusion (DD) and VITEK 2 Compact Automated Broth Microdilution (BMD) from flagged positive broth. In contrast, AST was performed by DD and BMD from isolated colonies.</div></div><div><h3>Results</h3><div>Among 95 Gram-negative bacteria (GNB), <em>E. coli</em> (n = 40), and <em>K. pneumoniae</em> (n = 19) were most common. RAST vs AST DD for GNB showed 91 % Categorical agreement (CA) with an overall Very Major Error (VME) and Major Error (ME) rates of 0.7 % & 2.2 % and respectively. For GNB, RAST vs. AST BMD demonstrated a CA of 97 % and Essential Agreement (EA) of 97.7 %, with VME and ME rates of 1.7 % (excluding <em>E.coli</em> + Cefepime drug bug pairs) and 0.1 % respectively.</div></div><div><h3>Conclusion</h3><div>These findings suggest that RAST is a reliable antimicrobial susceptibility tool for GNB from direct Blood Culture broths. RAST can support early initiation of targeted antimicrobial therapy in patients with sepsis.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"54 ","pages":"Article 100809"},"PeriodicalIF":1.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467881","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}
This case report describes the first documented fatal case of Leptospira wolffii in Sikkim, India, marking a novel geographic occurrence of leptospirosis in the Himalayan state. A 40-year-old female presented with fever, sepsis, and acute kidney injury, succumbing despite intensive care and antibiotic treatment. Targeted 16S rRNA sequencing confirmed a 100 % identity with L. wolffii. Phylogenetic analysis showed close relatedness to strains from Thailand, Bangladesh, and Assam. Environmental investigations revealed rodent infestation and livestock proximity as potential sources. This study underscores the need for awareness of leptospirosis in non-endemic regions, rapid diagnostics, and a one health approach to mitigate such outbreaks.
{"title":"Fatal case of Leptospira wolffii infection in Sikkim, India: An autochthonous case from a new geographical region","authors":"Shrijana Gurung , Dipesh Tewari , Urgen Sherpa , Tashi Pegey Chhophel , Aktarul Islam Siddique , Neelanjana Sarmah , Biswajyoti Borkakoty","doi":"10.1016/j.ijmmb.2025.100813","DOIUrl":"10.1016/j.ijmmb.2025.100813","url":null,"abstract":"<div><div>This case report describes the first documented fatal case of <em>Leptospira wolffii</em> in Sikkim, India, marking a novel geographic occurrence of leptospirosis in the Himalayan state. A 40-year-old female presented with fever, sepsis, and acute kidney injury, succumbing despite intensive care and antibiotic treatment. Targeted 16S rRNA sequencing confirmed a 100 % identity with <em>L. wolffii</em>. Phylogenetic analysis showed close relatedness to strains from Thailand, Bangladesh, and Assam. Environmental investigations revealed rodent infestation and livestock proximity as potential sources. This study underscores the need for awareness of leptospirosis in non-endemic regions, rapid diagnostics, and a one health approach to mitigate such outbreaks.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"54 ","pages":"Article 100813"},"PeriodicalIF":1.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476083","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 : 2025-02-22DOI: 10.1016/j.ijmmb.2025.100812
Ying Huang, Sushmita Pradhan, Yuping Ran
{"title":"Sebaceous nevus affected by overgrowth of Malassezia restricta.","authors":"Ying Huang, Sushmita Pradhan, Yuping Ran","doi":"10.1016/j.ijmmb.2025.100812","DOIUrl":"https://doi.org/10.1016/j.ijmmb.2025.100812","url":null,"abstract":"","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":" ","pages":"100812"},"PeriodicalIF":1.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491885","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}
In recent years, Myroides species have gained recognition as significant opportunistic pathogens, capable of inducing severe infections, especially in immunocompromised individuals. This case report documents an instance of urinary tract infection (UTI) caused by Myroides species in a 68-year-old man with a complex medical history, including both cryptococcal and tuberculous meningitis. Additionally, we explored the ultimate patient outcomes and present an up-to-date review of the scientific literature pertaining to UTIs associated with Myroides species. This case highlights the emerging importance of Myroides species in clinical settings and underscores the need for increased awareness among healthcare professionals.
{"title":"From obscurity to infamy: Myroides as an opportunistic Uropathogen - A clinical vignette and comprehensive review of literature","authors":"Debasish Biswal , Sanjay Pandey , Sandeep Mangla , Sadia Khan , Ananya Arora , Vibha Mehta , Pankhuri Kumari , Aayush Chawla , Anubhav Pandey , Sharmila Sengupta","doi":"10.1016/j.ijmmb.2025.100811","DOIUrl":"10.1016/j.ijmmb.2025.100811","url":null,"abstract":"<div><div>In recent years, <em>Myroides</em> species have gained recognition as significant opportunistic pathogens, capable of inducing severe infections, especially in immunocompromised individuals. This case report documents an instance of urinary tract infection (UTI) caused by <em>Myroides</em> species in a 68-year-old man with a complex medical history, including both cryptococcal and tuberculous meningitis. Additionally, we explored the ultimate patient outcomes and present an up-to-date review of the scientific literature pertaining to UTIs associated with <em>Myroides</em> species. This case highlights the emerging importance of <em>Myroides</em> species in clinical settings and underscores the need for increased awareness among healthcare professionals.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"54 ","pages":"Article 100811"},"PeriodicalIF":1.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453449","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}
Pneumococcal infections are a major cause of morbidity and mortality globally, especially among children in low- and middle-income countries (LMICs). Although considerable research has been done on the frequency of pneumococcal infections and their risk factors, there are still many unanswered questions. The objective of this study is to offer fresh perspectives through systematic literature review on the shifting prevalence of and associated risk factors for pneumococcal colonization.
Methods
A systematic search of literature from January 2012 to December 2023 was conducted using PubMed and Scopus, with keywords related to Streptococcus pneumoniae colonization and risk factors, and references were manually screened.
Results
Studies from 41 different countries are included in the evaluation, which focuses on pediatrics patients who are most vulnerable to pneumococcal infections. The most frequent risk variables for pneumococcal colonization were having siblings, daycare centers, passive smoking, household characteristics, age, comorbidities, and vaccination status. The frequency of pneumococcal colonization was greatest among LMICs, which may be related to inadequate pneumococcal vaccination programs, densely populated areas, and a lack of knowledge about basic sanitation and hygiene.
Conclusion
The study emphasizes how crucial it is to monitor serotype prevalence to direct vaccination campaigns in these regions. For creating efficient pneumococcal disease prevention and control strategies, it is essential to understand the risk factors connected to pneumococcal colonization. The review highlights the value of vaccination campaigns in lowering the prevalence of pneumococcal illness, to completely understand the relationship between immunization, serotype colonization, and the risk of pneumococcal colonization, more study is required especially in LIC and LMIC region.
{"title":"The enigmatic voyage of pneumococcal carriage: Unraveling the risk factors in pediatric populations -- A scoping review","authors":"Vaishnavi Vishram Naik , Subhangini Chakraborty , Krishnamurthy Jayanna , Tushar Shaw","doi":"10.1016/j.ijmmb.2025.100808","DOIUrl":"10.1016/j.ijmmb.2025.100808","url":null,"abstract":"<div><h3>Background</h3><div>Pneumococcal infections are a major cause of morbidity and mortality globally, especially among children in low- and middle-income countries (LMICs). Although considerable research has been done on the frequency of pneumococcal infections and their risk factors, there are still many unanswered questions. The objective of this study is to offer fresh perspectives through systematic literature review on the shifting prevalence of and associated risk factors for pneumococcal colonization.</div></div><div><h3>Methods</h3><div>A systematic search of literature from January 2012 to December 2023 was conducted using PubMed and Scopus, with keywords related to <em>Streptococcus pneumoniae</em> colonization and risk factors, and references were manually screened.</div></div><div><h3>Results</h3><div>Studies from 41 different countries are included in the evaluation, which focuses on pediatrics patients who are most vulnerable to pneumococcal infections. The most frequent risk variables for pneumococcal colonization were having siblings, daycare centers, passive smoking, household characteristics, age, comorbidities, and vaccination status. The frequency of pneumococcal colonization was greatest among LMICs, which may be related to inadequate pneumococcal vaccination programs, densely populated areas, and a lack of knowledge about basic sanitation and hygiene.</div></div><div><h3>Conclusion</h3><div>The study emphasizes how crucial it is to monitor serotype prevalence to direct vaccination campaigns in these regions. For creating efficient pneumococcal disease prevention and control strategies, it is essential to understand the risk factors connected to pneumococcal colonization. The review highlights the value of vaccination campaigns in lowering the prevalence of pneumococcal illness, to completely understand the relationship between immunization, serotype colonization, and the risk of pneumococcal colonization, more study is required especially in LIC and LMIC region.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"54 ","pages":"Article 100808"},"PeriodicalIF":1.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432341","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 virus infection in humans can also lead to severe complications like dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). The World Health Organization (WHO) estimates around 50 to 100 million dengue infections annually, with approximately 500,000 cases of DHF and 22,000 deaths, predominantly among children. The present study aimed at identifying circulating serotypes of dengue virus in patients by molecular techniques. Serotypes detected were correlated with the clinical profiles, complications, and outcomes in these patients.
Methods
This study was conducted between October 2019 to September 2022. Institute Ethics Committee approval was obtained (Reference no. IEC: RC/18/59). Serum from patients who tested positive for dengue NS1 antigen (NS1Ag) or anti-dengue immunoglobulin M (IgM) were serotyped by dengue reverse transcriptase polymerase chain reaction (RT-PCR). Clinical data was documented in case report forms and transferred to an Excel spreadsheet, and subsequently analyzed to correlate the dengue virus (DENV) serotype with clinical profile and outcome.
Results
The study population included 416 patients, confirmed by Dengue NS1Ag and or anti-Dengue IgM ELISA. Young adults (18–29 yrs) constituted the majority (56 %) of patients. About 85 % of all patients presented with fever, 10.6 % with hemorrhagic fever, and 4.4 % with shock syndrome. Thrombocytopenia with multiple bleeding manifestations was observed in 6.5 % of the patients. The predominant dengue serotype identified was serotype 3 from October 2019 to March 2021, and serotype 2 from April 2021 to September 2022, showing a shift in the serotypes affecting the patients.
Conclusion
Continuous sero- and molecular surveillance plays a crucial role in predicting dengue outbreaks and identifying shifts in circulating serotypes during the early phase of the dengue season. It may also play a role in vaccine preparedness for the control of dengue.
{"title":"Serotype and genotype shift detection over two consecutive periods of dengue virus infection in a tertiary care hospital","authors":"Sandhya Bhat K , Mailan Natarajan , Natarajan Vasanthi , Sudhagar Mookkappan , Bhavadharani Pandian , Shashikala Nair , Reba Kanungo","doi":"10.1016/j.ijmmb.2025.100807","DOIUrl":"10.1016/j.ijmmb.2025.100807","url":null,"abstract":"<div><h3>Purpose</h3><div>Dengue virus infection in humans can also lead to severe complications like dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). The World Health Organization (WHO) estimates around 50 to 100 million dengue infections annually, with approximately 500,000 cases of DHF and 22,000 deaths, predominantly among children. The present study aimed at identifying circulating serotypes of dengue virus in patients by molecular techniques. Serotypes detected were correlated with the clinical profiles, complications, and outcomes in these patients.</div></div><div><h3>Methods</h3><div>This study was conducted between October 2019 to September 2022. Institute Ethics Committee approval was obtained (Reference no. IEC: RC/18/59). Serum from patients who tested positive for dengue NS1 antigen (NS1Ag) or anti-dengue immunoglobulin M (IgM) were serotyped by dengue reverse transcriptase polymerase chain reaction (RT-PCR). Clinical data was documented in case report forms and transferred to an Excel spreadsheet, and subsequently analyzed to correlate the dengue virus (DENV) serotype with clinical profile and outcome.</div></div><div><h3>Results</h3><div>The study population included 416 patients, confirmed by Dengue NS1Ag and or anti-Dengue IgM ELISA. Young adults (18–29 yrs) constituted the majority (56 %) of patients. About 85 % of all patients presented with fever, 10.6 % with hemorrhagic fever, and 4.4 % with shock syndrome. Thrombocytopenia with multiple bleeding manifestations was observed in 6.5 % of the patients. The predominant dengue serotype identified was serotype 3 from October 2019 to March 2021, and serotype 2 from April 2021 to September 2022, showing a shift in the serotypes affecting the patients.</div></div><div><h3>Conclusion</h3><div>Continuous sero- and molecular surveillance plays a crucial role in predicting dengue outbreaks and identifying shifts in circulating serotypes during the early phase of the dengue season. It may also play a role in vaccine preparedness for the control of dengue.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"54 ","pages":"Article 100807"},"PeriodicalIF":1.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403201","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}
Cefiderocol is a parenteral catechol-type siderophore cephalosporin, which has been approved for the treatment of Gram-negative bacterial infections. Its activity among the carbapenem-resistant Gram-negative bacilli (CR-GNBs) in India is largely unknown.
Methodology
We tested in-vitro susceptibility of cefiderocol in 84 CR-GNB [ carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA), carbapenem-resistant Escherichia coli (CREC) and carbapenem-resistant Klebsiella pneumoniae (CRKP)] by broth microdilution (BMD) and disc diffusion (DD) using Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints and concordance of DD was compared with BMD. Cefiderocol susceptibility was evaluated based on the presence of blaNDM and blaOXA-48 genes.
Results
Following CLSI and EUCAST breakpoints, 76.2% [CRKP: 95.65% (22/23); CRPA: 80% (16/20); CREC: 65% (13/20); CRAB: 61.9% (13/21)] and 52.3% [ CRKP: 82.6% (19/23); CRPA: 50% (10/20); CREC: 20% (4/20)] of CR-GNBs were observed susceptible to cefiderocol, respectively. The susceptibility to cefiderocol was seen higher with lower MIC50 and MIC90 values for CRKP [1 μg/ml; 4 μg/ml ] and CRPA [2 μg/ml; 8 μg/ml ] in comparison to the other two groups of organisms. The categorical agreement between BMD and DD was found between 90% and 100% for all organisms. Cefiderocol susceptibility among the isolates harbouring blaNDM, blaOXA-48, and both blaNDM and blaOXA-48 genes was observed 75% (24/32); 100% (3/3); and 66.6% (4/6), respectively.
Conclusion
Cefiderocol demonstrated high in-vitro activity against CRKP and CRPA isolates from India with lower MIC50 and MIC90 irrespective of the presence of blaNDM and blaOXA-48 genes.
{"title":"In-vitro susceptibility of cefiderocol and other comparators in carbapenem-resistant Gram-negative bacilli: A study from India","authors":"Akansha Didwania , Sarita Mohapatra , Deepak Kocher , Hitender Gautam , Priyanka Kumari , Arvind Kumar , Manish Soneja , Naval K. Vikram , Seema Sood , Benu Dhawan , Bimal Kumar Das , Rama Chaudhry , Manoranjan Mahapatra , Naveet Wig , Arti Kapil","doi":"10.1016/j.ijmmb.2025.100793","DOIUrl":"10.1016/j.ijmmb.2025.100793","url":null,"abstract":"<div><h3>Introduction</h3><div>Cefiderocol is a parenteral catechol-type siderophore cephalosporin, which has been approved for the treatment of Gram-negative bacterial infections. Its activity among the carbapenem-resistant Gram-negative bacilli (CR-GNBs) in India is largely unknown.</div></div><div><h3>Methodology</h3><div>We tested <em>in-vitro</em> susceptibility of cefiderocol in 84 CR-GNB [ carbapenem-resistant <em>Acinetobacter baumannii</em> (CRAB), carbapenem-resistant <em>Pseudomonas aeruginosa</em> (CRPA), carbapenem-resistant <em>Escherichia coli</em> (CREC) and carbapenem-resistant <em>Klebsiella pneumoniae</em> (CRKP)] by broth microdilution (BMD) and disc diffusion (DD) using Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints and concordance of DD was compared with BMD. Cefiderocol susceptibility was evaluated based on the presence of <em>bla</em><sub>NDM</sub> and <em>bla</em><sub>OXA-48</sub> genes.</div></div><div><h3>Results</h3><div>Following CLSI and EUCAST breakpoints, 76.2% [CRKP: 95.65% (22/23); CRPA: 80% (16/20); CREC: 65% (13/20); CRAB: 61.9% (13/21)] and 52.3% [ CRKP: 82.6% (19/23); CRPA: 50% (10/20); CREC: 20% (4/20)] of CR-GNBs were observed susceptible to cefiderocol, respectively. The susceptibility to cefiderocol was seen higher with lower MIC<sub>50</sub> and MIC<sub>90</sub> values for CRKP [1 μg/ml; 4 μg/ml ] and CRPA [2 μg/ml; 8 μg/ml ] in comparison to the other two groups of organisms. The categorical agreement between BMD and DD was found between 90% and 100% for all organisms. Cefiderocol susceptibility among the isolates harbouring <em>bla</em><sub>NDM</sub>, <em>bla</em><sub>OXA-48</sub>, and both <em>bla</em><sub>NDM</sub> and <em>bla</em><sub>OXA-48</sub> genes was observed 75% (24/32); 100% (3/3); and 66.6% (4/6), respectively.</div></div><div><h3>Conclusion</h3><div>Cefiderocol demonstrated high <em>in-vitro</em> activity against CRKP and CRPA isolates from India with lower MIC<sub>50</sub> and MIC<sub>90</sub> irrespective of the presence of <em>bla</em><sub>NDM</sub> and <em>bla</em><sub>OXA-48</sub> genes.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"54 ","pages":"Article 100793"},"PeriodicalIF":1.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065420","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}
Tuberculous pyomyositis is an uncommon form of extrapulmonary tuberculosis (EPTB). We report a rare case of EPTB in a 34-year-old male post-renal transplant recipient. He presented with pain in the left hip region and fever 9 years after the renal transplantation. A tender swelling was noted over the left hip region, visualized as a loculated hyperintense lesion on MRI. Ultrasound-guided aspiration revealed a purulent discharge which showed acid-fast bacilli on Ziehl-Neelsen staining. GeneXpert MTB confirmed the presence of Mycobacterium tuberculosis, sensitive to Rifampicin. The patient was diagnosed with tuberculous pyomyositis. Antitubercular treatment (ATT) was started and the abscess was drained.
{"title":"A rare encounter: Tuberculous pyomyositis in an immunosuppressed post-transplant patient","authors":"Sai Kavya Sree , Stephen Raj , Mani Bhushan Kumar , Rakesh Yadav , Sunil Kumar Dhatwalia , Vanji Nathan Subramani , Mahesh Prakash , Sunil Sethi","doi":"10.1016/j.ijmmb.2025.100791","DOIUrl":"10.1016/j.ijmmb.2025.100791","url":null,"abstract":"<div><div>Tuberculous pyomyositis is an uncommon form of extrapulmonary tuberculosis (EPTB). We report a rare case of EPTB in a 34-year-old male post-renal transplant recipient. He presented with pain in the left hip region and fever 9 years after the renal transplantation. A tender swelling was noted over the left hip region, visualized as a loculated hyperintense lesion on MRI. Ultrasound-guided aspiration revealed a purulent discharge which showed acid-fast bacilli on Ziehl-Neelsen staining. GeneXpert MTB confirmed the presence of <em>Mycobacterium tuberculosis,</em> sensitive to Rifampicin. The patient was diagnosed with tuberculous pyomyositis. Antitubercular treatment (ATT) was started and the abscess was drained.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"54 ","pages":"Article 100791"},"PeriodicalIF":1.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038230","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}
Vancomycin has been the preferred treatment for MRSA infections. However, newer drugs are necessary due to the increasing prevalence of MRSA isolates that are less susceptible to vancomycin. Levonadifloxacin and its prodrug alalevonadifloxacin, novel quinolones with broad spectrum anti-MRSA activity. They are approved in India for the treatment of skin and soft-tissue infections, bacteraemia, and diabetic foot infections.
Materials and methods
A total of 456 MRSA (Methicillin-resistant Staphylococcus aureus) isolates, including 333 isolates from JIPMER and 123 isolates from other tertiary care centers collected between January to December 2022, underwent susceptibility testing to levonadifloxacin by disc diffusion method. The study isolates included 29 h-VISA. Fifty one blood isolates were also subjected to E-test and their results were compared to the gold standard, broth micro dilution (BMD).
Result
All 456 isolates were found to be susceptible to levonadifloxacin by disc diffusion. Levonadifloxacin demonstrated potent activity against MRSA strains isolated from blood (n = 51) with an MIC50 and MIC90 of 0.38 and 0.5 μg/mL by E-test, respectively. Similarly, it demonstrated an MIC50 and MIC90 of 0.5 & 1 μg/ml by BMD.
Conclusion
The present study demonstrated 100 % susceptibility to levonadifloxacin among the tested isolates of MRSA, highlighting its promising clinical potential for treating infections caused by this organism. Furthermore, the study recorded a concordance of 100 % between disc diffusion and Etest method with BMD, indicating the reliability of these methods.
{"title":"In vitro efficacy of levonadifloxacin against methicillin-resistant Staphylococcus aureus (MRSA) including hVISA isolates collected across India","authors":"Sneha Vinayan , Sujatha Sistla , Meerabai Manoharan , Kamini walia , Madhan Sugumar","doi":"10.1016/j.ijmmb.2025.100788","DOIUrl":"10.1016/j.ijmmb.2025.100788","url":null,"abstract":"<div><h3>Background</h3><div>Vancomycin has been the preferred treatment for MRSA infections. However, newer drugs are necessary due to the increasing prevalence of MRSA isolates that are less susceptible to vancomycin. Levonadifloxacin and its prodrug alalevonadifloxacin, novel quinolones with broad spectrum anti-MRSA activity. They are approved in India for the treatment of skin and soft-tissue infections, bacteraemia, and diabetic foot infections.</div></div><div><h3>Materials and methods</h3><div>A total of 456 MRSA (Methicillin-resistant <em>Staphylococcus aureus</em>) isolates, including 333 isolates from JIPMER and 123 isolates from other tertiary care centers collected between January to December 2022, underwent susceptibility testing to levonadifloxacin by disc diffusion method. The study isolates included 29 h-VISA. Fifty one blood isolates were also subjected to E-test and their results were compared to the gold standard, broth micro dilution (BMD).</div></div><div><h3>Result</h3><div>All 456 isolates were found to be susceptible to levonadifloxacin by disc diffusion. Levonadifloxacin demonstrated potent activity against MRSA strains isolated from blood (n = 51) with an MIC<sub>50</sub> and MIC<sub>90</sub> of 0.38 and 0.5 μg/mL by E-test, respectively. Similarly, it demonstrated an MIC<sub>50</sub> and MIC<sub>90</sub> of 0.5 & 1 μg/ml by BMD.</div></div><div><h3>Conclusion</h3><div>The present study demonstrated 100 % susceptibility to levonadifloxacin among the tested isolates of MRSA, highlighting its promising clinical potential for treating infections caused by this organism. Furthermore, the study recorded a concordance of 100 % between disc diffusion and Etest method with BMD, indicating the reliability of these methods.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"53 ","pages":"Article 100788"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948089","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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