Pub Date : 2025-11-01Epub Date: 2025-10-02DOI: 10.1016/j.ijmmb.2025.100986
Balakrishnan Arivalagan , Zaheer Qureshi , Rohit Vashisht , Rabih Nasr , Sabah Afroze
Purple urine bag syndrome (PUBS) is an uncommon but visually striking condition characterized by purple discoloration of urine. It occurs due to the production of pigments that result from tryptophan metabolism by certain bacteria (Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Escherichia coli, Providencia spp). We discuss a case of PUBS in a male with obstructive uropathy and long-term catheterization. This report emphasizes the clinicians to consider PUBS when encountering purple urine, particularly in patients with risk factors such as long-term catheterization and urinary tract infections. Management of PUBS involves periodic catheter change, alleviation of risk factors and stringent sanitation practices.
{"title":"Asymptomatic urinary tract infection manifesting as purple urine","authors":"Balakrishnan Arivalagan , Zaheer Qureshi , Rohit Vashisht , Rabih Nasr , Sabah Afroze","doi":"10.1016/j.ijmmb.2025.100986","DOIUrl":"10.1016/j.ijmmb.2025.100986","url":null,"abstract":"<div><div>Purple urine bag syndrome (PUBS) is an uncommon but visually striking condition characterized by purple discoloration of urine. It occurs due to the production of pigments that result from tryptophan metabolism by certain bacteria (<em>Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Escherichia coli, Providencia</em> spp). We discuss a case of PUBS in a male with obstructive uropathy and long-term catheterization. This report emphasizes the clinicians to consider PUBS when encountering purple urine, particularly in patients with risk factors such as long-term catheterization and urinary tract infections. Management of PUBS involves periodic catheter change, alleviation of risk factors and stringent sanitation practices.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"58 ","pages":"Article 100986"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228451","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}
Enterococcal bloodstream infections (E-BSIs) pose a significant challenge due to their unique intrinsic and increasing resistance. Empirical treatment guidelines are often ineffective in E-BSI, as Antibiotic policies mainly address Gram-negative bacilli and MRSA for Hospital-acquired infection (HAI) in India.
Methods
The study was designed to investigate the risk factors, infection source, species profile, antimicrobial susceptibility and clinical outcomes in diagnosed E-BSI patients at a tertiary care centre in India.
From the blood culture samples from August 2022 to July 2023, 52 non-duplicate blood culture isolates of Enterococcus species were identified with categorisation of vancomycin resistance genes, and the patients were followed up for risk factors, probable sources, and ongoing therapies, with a switch to definitive therapy for the outcome.
Results
Of 52 confirmed E-BSI cases, the species distribution was as follows: E. faecium (61.5 %), E. faecalis (26.92 %), E. gallinarum (9.61 %), and E. durans (1.92 %). Antimicrobial resistance was significantly higher in E. faecium. Nine isolates (17.3 %) were vancomycin-resistant enterococci (VRE), with diverse outcomes. HAI comprised 44.23 % of cases. The overall mortality rate was 26.9 % and ICU patients had significantly higher mortality, with significant risk factors being invasive medical devices (59.6 %), followed by bedridden status (23 %) and immunosuppression (9.61 %). Significant risk factors included the presence of invasive medical devices (59.6 %), followed by a bedridden status (23.0 %) and immunosuppression (9.6 %). Patients with early empirical therapy that has enterococcal coverage showed a protective effect on survival. However, switching over to definitive therapy alone could not significantly reduce mortality.
Conclusion
This study underscores the importance of early empirical therapy with enterococcal coverage in high-risk patients. Timely initiation of empirical coverage appears more crucial than later definitive therapy adjustments in improving survival. Invasive device use remains a significant risk factor, reinforcing the need for stringent infection control to prevent HAI, including E-BSI.
{"title":"A risk-based assessment of Enterococcal Bloodstream infection: Suggesting considerations in empirical therapy strategies in a tertiary care hospital","authors":"Pooja Kumar, Bhaskar Thakuria, Binod Kumar Pati, K. Prathyusha, Asim Sarfraz, Archana","doi":"10.1016/j.ijmmb.2025.100976","DOIUrl":"10.1016/j.ijmmb.2025.100976","url":null,"abstract":"<div><h3>Purpose</h3><div>Enterococcal bloodstream infections (E-BSIs) pose a significant challenge due to their unique intrinsic and increasing resistance. Empirical treatment guidelines are often ineffective in E-BSI, as Antibiotic policies mainly address Gram-negative bacilli and MRSA for Hospital-acquired infection (HAI) in India.</div></div><div><h3>Methods</h3><div>The study was designed to investigate the risk factors, infection source, species profile, antimicrobial susceptibility and clinical outcomes in diagnosed E-BSI patients at a tertiary care centre in India.</div><div>From the blood culture samples from August 2022 to July 2023, 52 non-duplicate blood culture isolates of <em>Enterococcus</em> species were identified with categorisation of vancomycin resistance genes, and the patients were followed up for risk factors, probable sources, and ongoing therapies, with a switch to definitive therapy for the outcome.</div></div><div><h3>Results</h3><div>Of 52 confirmed E-BSI cases, the species distribution was as follows: <em>E. faecium</em> (61.5 %), <em>E. faecalis</em> (26.92 %), <em>E. gallinarum</em> (9.61 %), and <em>E. durans</em> (1.92 %). Antimicrobial resistance was significantly higher in <em>E. faecium</em>. Nine isolates (17.3 %) were vancomycin-resistant enterococci (VRE), with diverse outcomes. HAI comprised 44.23 % of cases. The overall mortality rate was 26.9 % and ICU patients had significantly higher mortality, with significant risk factors being invasive medical devices (59.6 %), followed by bedridden status (23 %) and immunosuppression (9.61 %). Significant risk factors included the presence of invasive medical devices (59.6 %), followed by a bedridden status (23.0 %) and immunosuppression (9.6 %). Patients with early empirical therapy that has enterococcal coverage showed a protective effect on survival. However, switching over to definitive therapy alone could not significantly reduce mortality.</div></div><div><h3>Conclusion</h3><div>This study underscores the importance of early empirical therapy with enterococcal coverage in high-risk patients. Timely initiation of empirical coverage appears more crucial than later definitive therapy adjustments in improving survival. Invasive device use remains a significant risk factor, reinforcing the need for stringent infection control to prevent HAI, including E-BSI.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"58 ","pages":"Article 100976"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102823","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 : 2025-09-01Epub Date: 2025-07-25DOI: 10.1016/j.ijmmb.2025.100941
Chinnu Liz Sebastian , Sabarish B. Nair , K.P. Gireesh Kumar , Abin Thomas , Liyona Varghese , Mary Francis , Anil Kumar
Kytococcus schroeteri is a Gram positive cocci usually found as a coloniser of the human skin and mucous membrane. It is a bacterium that is usually considered a contaminant in blood cultures. It can rarely cause infective endocarditis and is usually associated with prosthetic heart valve endocarditis. We report a case of early prosthetic valve endocarditis in a 78-year-old female and provide a brief review of similar cases published in the literature.
{"title":"Early prosthetic valve endocarditis due to Kytococcus schroeteri – A case report and review of literature","authors":"Chinnu Liz Sebastian , Sabarish B. Nair , K.P. Gireesh Kumar , Abin Thomas , Liyona Varghese , Mary Francis , Anil Kumar","doi":"10.1016/j.ijmmb.2025.100941","DOIUrl":"10.1016/j.ijmmb.2025.100941","url":null,"abstract":"<div><div><em>Kytococcus schroeteri</em> is a Gram positive cocci usually found as a coloniser of the human skin and mucous membrane. It is a bacterium that is usually considered a contaminant in blood cultures. It can rarely cause infective endocarditis and is usually associated with prosthetic heart valve endocarditis. We report a case of early prosthetic valve endocarditis in a 78-year-old female and provide a brief review of similar cases published in the literature.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"57 ","pages":"Article 100941"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730117","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 : 2025-09-01Epub Date: 2025-08-14DOI: 10.1016/j.ijmmb.2025.100952
Bhaskar Jyoti Das , Jayalaxmi Wangkheimayum , Mahmadur Rashid , Sonali Chealsea Singha , Deepjyoti Paul , K. Melson Singha , Debadatta Dhar Chanda , Amitabha Bhattacharjee
Purpose
Chromobacterium violaceum is an opportunistic environmental pathogen, which act as a potential source of antimicrobial resistance genes. Acquisition of such genes by non-susceptible organisms, aided by mobile genetic elements possess a serious clinical threat. With the rise and expansion of carbapenem resistance worldwide, the present study investigates two carbapenem non-susceptible Chromobacterium violaceum isolates through whole genome sequencing.
Methods
The study isolates were assessed for ESBLs and carbapenemases production using combined disc diffusion and Carba NP tests respectively. Susceptibility of the isolates were checked following CLSI guidelines. PCR assays targeting different resistance genes were performed followed by transformation and conjugation experiments to investigate the transferability of carbapenemase-encoding gene. Whole genome sequencing was carried out using Illumina NovaSeq 6000 platform and the data generated were analysed using bioinformatic tools.
Results
The Chromobacterium violaceum isolates obtained in the study were harbouring the carbapenemase-encoding gene blaOXA-232 along with the carriage of ESBLs, AMEs and sulphonamides genes. The carbapenemase-encoding gene was carried within a non-conjugative plasmid, however, was found associated with the insertion sequence ISEcp1, which was located upstream of blaOXA-232. The AME gene aac(3)-IIc was found associated with two different insertion sequences ISCpi1 and ISStma1. The carriage of proteins corresponding pathogenic families, the study isolates were predicted to be a human pathogen (probability of 0.85). The Chromobacterium violaceum isolates harboured extrachromosomal DNA along with intact prophage regions.
Conclusions
Chromobacterium violaceum harboring the emerging OXA-48 variant blaOXA-232 along with multiple resistance determinants within clinical-environmental interface is a serious health hazard as it might serve as a source and vector for their transmission in different settings, thereby, increasing the antimicrobial resistance burden. The study warrants urgent monitoring of these resistance determinants to thwart their future dissemination.
{"title":"Incidence of carbapenem non-susceptible Chromobacterium violaceum harboring blaOXA-232 from clinical-environmental interface","authors":"Bhaskar Jyoti Das , Jayalaxmi Wangkheimayum , Mahmadur Rashid , Sonali Chealsea Singha , Deepjyoti Paul , K. Melson Singha , Debadatta Dhar Chanda , Amitabha Bhattacharjee","doi":"10.1016/j.ijmmb.2025.100952","DOIUrl":"10.1016/j.ijmmb.2025.100952","url":null,"abstract":"<div><h3>Purpose</h3><div><em>Chromobacterium violaceum</em> is an opportunistic environmental pathogen, which act as a potential source of antimicrobial resistance genes. Acquisition of such genes by non-susceptible organisms, aided by mobile genetic elements possess a serious clinical threat. With the rise and expansion of carbapenem resistance worldwide, the present study investigates two carbapenem non-susceptible <em>Chromobacterium violaceum</em> isolates through whole genome sequencing.</div></div><div><h3>Methods</h3><div>The study isolates were assessed for ESBLs and carbapenemases production using combined disc diffusion and Carba NP tests respectively. Susceptibility of the isolates were checked following CLSI guidelines. PCR assays targeting different resistance genes were performed followed by transformation and conjugation experiments to investigate the transferability of carbapenemase-encoding gene. Whole genome sequencing was carried out using Illumina NovaSeq 6000 platform and the data generated were analysed using bioinformatic tools.</div></div><div><h3>Results</h3><div>The <em>Chromobacterium violaceum</em> isolates obtained in the study were harbouring the carbapenemase-encoding gene <em>bla</em><sub>OXA-232</sub> along with the carriage of ESBLs, AMEs and sulphonamides genes. The carbapenemase-encoding gene was carried within a non-conjugative plasmid, however, was found associated with the insertion sequence IS<em>Ecp1</em>, which was located upstream of <em>bla</em><sub>OXA-232</sub>. The AME gene <em>aac(3)-IIc</em> was found associated with two different insertion sequences <em>ISCpi1</em> and <em>ISStma1</em>. The carriage of proteins corresponding pathogenic families, the study isolates were predicted to be a human pathogen (probability of 0.85). The <em>Chromobacterium violaceum</em> isolates harboured extrachromosomal DNA along with intact prophage regions.</div></div><div><h3>Conclusions</h3><div><em>Chromobacterium violaceum</em> harboring the emerging OXA-48 variant <em>bla</em><sub>OXA-232</sub> along with multiple resistance determinants within clinical-environmental interface is a serious health hazard as it might serve as a source and vector for their transmission in different settings, thereby, increasing the antimicrobial resistance burden. The study warrants urgent monitoring of these resistance determinants to thwart their future dissemination.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"57 ","pages":"Article 100952"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862145","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 : 2025-09-01Epub Date: 2025-07-17DOI: 10.1016/j.ijmmb.2025.100937
Jayanti Jena , Bijayini Behera , Srujana Mohanty , Baijayantimala Mishra , Prasanta R. Mohapatra , Asmita Patnaik
Purpose
The association of variably expressed virulence factors, such as the O antigen of Lipopolysaccharide (LPS), Burkholderia intracellular motility factor (bimA), and filamentous hemagglutinin (fhaB3) in the Burkholderia pseudomallei genome, with diverse clinical manifestations and outcomes, was explored in 100 B. pseudomallei isolates.
Methods
One hundred consecutive B. pseudomallei isolates from melioidosis patients (30 deep organ abscesses, 15 community-acquired pneumonia, 18 bacteremia without focus, 10 neuromelioidosis,8 bone, and joint infections, and 19 subcutaneous abscesses) diagnosed between April 15, 2021 to Dec 31, 2023 in a hospital in Odisha in Eastern India were evaluated for their LPS O-antigen genotype, bimA genotype, and fhaB3 genotype by polymerase chain reaction (PCR) and their association with clinical syndrome, seasonality, ICU admission or mortality. The results were also compared with findings from other regions in India, Southeast Asia, and Australia.
Results
LPS A (40 %) was the predominant type, followed by LPS B (13 %), and LPS B2 was detected from a single case of septic arthritis. Forty-seven B. pseudomallei isolates could not be assigned to any LPS genotypes. All isolates had bimABp variant, and ninety-eight isolates were positive for fhaB3. There was no association between any variable virulence factors examined with clinical outcome. We found notable LPS genotypic differences between clinical B. pseudomallei isolates in our study and isolates from other regions in India, Southeast Asia, and Australia.
Conclusions
India is believed to be a melioidosis hot spot country, and the genetic heterogeneity of LPS in various parts of India (40 % LPS A, 13 % LPS B, 1 % LPSB2 in the present study from Eastern India, 65.7 % LPS A, 6 % LPS B, no LPS B2 in southern India, 74 % LPS B, 20.6 % LPS A, 5.5 % LPS B2 in south-western Coastal India) needs to be explored further in other parts of India as genetic markers for geospatial analysis within India.
{"title":"Study of the association of Burkholderia pseudomallei lipopolysaccharide genotypes and variable virulence factors with different clinical manifestations of melioidosis","authors":"Jayanti Jena , Bijayini Behera , Srujana Mohanty , Baijayantimala Mishra , Prasanta R. Mohapatra , Asmita Patnaik","doi":"10.1016/j.ijmmb.2025.100937","DOIUrl":"10.1016/j.ijmmb.2025.100937","url":null,"abstract":"<div><h3>Purpose</h3><div>The association of variably expressed virulence factors, such as the O antigen of Lipopolysaccharide (LPS), Burkholderia intracellular motility factor (bimA), and filamentous hemagglutinin (fhaB3) in the Burkholderia pseudomallei genome, with diverse clinical manifestations and outcomes, was explored in 100 <em>B. pseudomallei</em> isolates.</div></div><div><h3>Methods</h3><div>One hundred consecutive <em>B. pseudomallei</em> isolates from melioidosis patients (30 deep organ abscesses, 15 community-acquired pneumonia, 18 bacteremia without focus, 10 neuromelioidosis,8 bone, and joint infections, and 19 subcutaneous abscesses) diagnosed between April 15, 2021 to Dec 31, 2023 in a hospital in Odisha in Eastern India were evaluated for their LPS O-antigen genotype, <em>bimA</em> genotype, and <em>fhaB3</em> genotype by polymerase chain reaction (PCR) and their association with clinical syndrome, seasonality, ICU admission or mortality. The results were also compared with findings from other regions in India, Southeast Asia, and Australia.</div></div><div><h3>Results</h3><div>LPS A (40 %) was the predominant type, followed by LPS B (13 %), and LPS B2 was detected from a single case of septic arthritis. Forty-seven <em>B. pseudomallei</em> isolates could not be assigned to any LPS genotypes. All isolates had <em>bimABp</em> variant, and ninety-eight isolates were positive for <em>fhaB3</em>. There was no association between any variable virulence factors examined with clinical outcome. We found notable LPS genotypic differences between clinical <em>B. pseudomallei</em> isolates in our study and isolates from other regions in India, Southeast Asia, and Australia.</div></div><div><h3>Conclusions</h3><div>India is believed to be a melioidosis hot spot country, and the genetic heterogeneity of LPS in various parts of India (40 % LPS A, 13 % LPS B, 1 % LPSB2 in the present study from Eastern India, 65.7 % LPS A, 6 % LPS B, no LPS B2 in southern India, 74 % LPS B, 20.6 % LPS A, 5.5 % LPS B2 in south-western Coastal India) needs to be explored further in other parts of India as genetic markers for geospatial analysis within India.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"57 ","pages":"Article 100937"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667579","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 molecular epidemiological methods are important in the study of transmission dynamics and population structure of Mycobacterium tuberculosis strains circulating in a geographical region.
Methods
A total of 104 patients were selected who were diagnosed for the first time with pulmonary tuberculosis and were sputum smear positive. Drug sensitivity test, spoligotyping, and MIRU-VNTR typing were done with all strains.
Results
In our series, three isolates were resistant to all the four agents, while 13(12.5 %) were classified as multi-drug resistant. Spoligotyping revealed the predominance of East African-India (EAI) lineage (66.3 %) with EAI 3-Ind (44.2 %) and EAI 5 (18.2 %) making up the majority. Our study found no presence of Beijing strains, while 15 isolates exhibited 9 distinct spoligotyping patterns (orphan or novel) that are not listed in the spoligotyping database. Three strains belonging to CAS1-Delhi, EAI3-Ind, and Manu1 lineages were resistant to all four anti-tuberculosis agents. The discriminatory power of various MIRU-VNTR alleles was found to be lower for EAI family strains compared to Non-EAI family strains. The clustering rates of MIRU-VNTR and Spoligotyping were 0.52 and 0.711 respectively. The neighbor-joining tree, based on 24-loci MIRU-VNTR typing, revealed two main clusters: one group included the CAS1-Delhi, LAM6, Cameroon, and MANU families, while the other group contained the EAI family.
Conclusions
The finding of half of the strains resistant to one or more anti-tuberculosis drugs and 12.5 % MDR strains emphasizes the importance of susceptibility testing before initiation of treatment.EAI lineage is considered to be predominant in Southern part of India which was corroborated in our study. MIRU-VNTR should be used in addition to spoligotyping since it has got finer discriminatory power. Molecular epidemiological studies should be performed periodically to assess the circulating strains in a particular geographic area.
{"title":"“Genetic diversity of Mycobacterium tuberculosis complex in treatment naive sputum smear positive patients as revealed by spoligotyping and MIRU-VNTR.”","authors":"Anagoni Srikar , B.V. Ramana , P.V.G.K. Sarma , Alladi Mohan , Abhijit Chaudhury","doi":"10.1016/j.ijmmb.2025.100939","DOIUrl":"10.1016/j.ijmmb.2025.100939","url":null,"abstract":"<div><h3>Purpose</h3><div>The molecular epidemiological methods are important in the study of transmission dynamics and population structure of <em>Mycobacterium tuberculosis</em> strains circulating in a geographical region.</div></div><div><h3>Methods</h3><div>A total of 104 patients were selected who were diagnosed for the first time with pulmonary tuberculosis and were sputum smear positive. Drug sensitivity test, spoligotyping, and MIRU-VNTR typing were done with all strains.</div></div><div><h3>Results</h3><div>In our series, three isolates were resistant to all the four agents, while 13(12.5 %) were classified as multi-drug resistant. Spoligotyping revealed the predominance of East African-India (EAI) lineage (66.3 %) with EAI 3-Ind (44.2 %) and EAI 5 (18.2 %) making up the majority. Our study found no presence of Beijing strains, while 15 isolates exhibited 9 distinct spoligotyping patterns (orphan or novel) that are not listed in the spoligotyping database. Three strains belonging to CAS1-Delhi, EAI3-Ind, and Manu1 lineages were resistant to all four anti-tuberculosis agents. The discriminatory power of various MIRU-VNTR alleles was found to be lower for EAI family strains compared to Non-EAI family strains. The clustering rates of MIRU-VNTR and Spoligotyping were 0.52 and 0.711 respectively. The neighbor-joining tree, based on 24-loci MIRU-VNTR typing, revealed two main clusters: one group included the CAS1-Delhi, LAM6, Cameroon, and MANU families, while the other group contained the EAI family.</div></div><div><h3>Conclusions</h3><div>The finding of half of the strains resistant to one or more anti-tuberculosis drugs and 12.5 % MDR strains emphasizes the importance of susceptibility testing before initiation of treatment.EAI lineage is considered to be predominant in Southern part of India which was corroborated in our study. MIRU-VNTR should be used in addition to spoligotyping since it has got finer discriminatory power. Molecular epidemiological studies should be performed periodically to assess the circulating strains in a particular geographic area.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"57 ","pages":"Article 100939"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674575","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 : 2025-09-01Epub Date: 2025-08-22DOI: 10.1016/j.ijmmb.2025.100955
Suruchi Shukla , Kalpana Kuntal , Shantanu Prakash , Amit Bhagat , Zeba Malik , Vimala Venkatesh , Gopa Banerjee
Background
Cystic echinococcosis, a zoonotic parasitic disease, is caused by the larvae of Echinococcus granulosus. It is a global public health problem with significant disease burden in India.
Objective
To determine the prevalence and epidemiological characteristics of cystic echinococcosis (CE) in the study population, thereby providing insights into its burden, seasonal trends, and geographical distribution to inform effective control and prevention strategies.
Methodology
This prospective study evaluated the seroprevalence of human cystic echinococcosis (CE) in 545 serum samples collected at a tertiary care hospital from August 2022 to July 2024. Clinical and laboratory data from patients with suspected CE were analyzed to identify associations with demographic and geographical factors. Statistical tests, including the Chi-square test, were conducted to explore the trends, correlations, and risk factors in patients with CE.
Results
Of the 545 serum samples tested, 252 (46.23 %) were positive for Cystic Echinococcosis IgG antibodies. The age group of >18–49 years had a significantly higher number of seropositive patients (p = 0.019). A statistically significant association was found between gender and cystic echinococcosis, with males showing a significantly higher seropositivity rate compared to females (M:F-1.2:1). Rural residence and a history of contact with dogs was strongly associated with a higher rate of CE seropositivity. Among these 252 seropositive patients, majority of cases were seen in liver (56.7 %, 143) followed by lung (23.4 %), both liver and lung (10.7 %), spleen (3.96 %), and kidney (1.58 %).The districts with the highest seropositivity for Echinococcus granulosus cases were Lucknow and Raebareli followed by Sitapur and Barabanki.
Conclusion
The high prevalence of Cystic Echinococcosis according to this study highlights the need for surveillance and integrated control measures to prevent this disease in humans and livestock across the country. Addressing this issue in India requires a One Health approach integrating human, animal, and environmental health strategies.
{"title":"Unveiling cystic echinococcosis: Seroprevalence trends and risk dynamics in Northern India","authors":"Suruchi Shukla , Kalpana Kuntal , Shantanu Prakash , Amit Bhagat , Zeba Malik , Vimala Venkatesh , Gopa Banerjee","doi":"10.1016/j.ijmmb.2025.100955","DOIUrl":"10.1016/j.ijmmb.2025.100955","url":null,"abstract":"<div><h3>Background</h3><div>Cystic echinococcosis, a zoonotic parasitic disease, is caused by the larvae of <em>Echinococcus granulosus</em>. It is a global public health problem with significant disease burden in India.</div></div><div><h3>Objective</h3><div>To determine the prevalence and epidemiological characteristics of cystic echinococcosis (CE) in the study population, thereby providing insights into its burden, seasonal trends, and geographical distribution to inform effective control and prevention strategies.</div></div><div><h3>Methodology</h3><div>This prospective study evaluated the seroprevalence of human cystic echinococcosis (CE) in 545 serum samples collected at a tertiary care hospital from August 2022 to July 2024. Clinical and laboratory data from patients with suspected CE were analyzed to identify associations with demographic and geographical factors. Statistical tests, including the Chi-square test, were conducted to explore the trends, correlations, and risk factors in patients with CE.</div></div><div><h3>Results</h3><div>Of the 545 serum samples tested, 252 (46.23 %) were positive for Cystic Echinococcosis IgG antibodies. The age group of >18–49 years had a significantly higher number of seropositive patients (p = 0.019). A statistically significant association was found between gender and cystic echinococcosis, with males showing a significantly higher seropositivity rate compared to females (M:F-1.2:1). Rural residence and a history of contact with dogs was strongly associated with a higher rate of CE seropositivity. Among these 252 seropositive patients, majority of cases were seen in liver (56.7 %, 143) followed by lung (23.4 %), both liver and lung (10.7 %), spleen (3.96 %), and kidney (1.58 %).The districts with the highest seropositivity for <em>Echinococcus granulosus</em> cases were Lucknow and Raebareli followed by Sitapur and Barabanki.</div></div><div><h3>Conclusion</h3><div>The high prevalence of Cystic Echinococcosis according to this study highlights the need for surveillance and integrated control measures to prevent this disease in humans and livestock across the country. Addressing this issue in India requires a One Health approach integrating human, animal, and environmental health strategies.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"57 ","pages":"Article 100955"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896026","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}
Purpose: Recent years have witnessed a notable rise in mumps cases globally, despite the availability of vaccination. This study aims to identify the consistent mutations in mumps virus strains isolated from Odisha in 2024, which may have contributed to the increased transmission of mumps in the country.
Methods: A study was conducted involving 32 mumps patients aged 0-45 years who visited a tertiary care hospital in Eastern India. All oropharyngeal swab samples collected from patients underwent RNA extraction, followed by cDNA synthesis. Thereafter, the viral SH gene underwent PCR amplification, and the positive samples were processed for sequencing. A phylogenetic tree was constructed utilizing the MEGA software for identification of viral genotype. Moreover, the current viral SH gene sequences underwent alignment with global sequences utilizing the Clustal W tool for mutational analysis. An in-silico analysis has also been conducted to elucidate the functional implications of any consistent mutation.
Results: All current mumps isolates are classified under genotype C and formed a unique cluster within the phylogenetic tree. Moreover, the entire SH protein sequence was conserved across all global genotype C strains, with the notable exception of the Y44S substitution. Additionally, the in-silico analysis revealed that the above mutation may alter the flexibility of the secondary structure of the SH protein. Furthermore, this mutation is anticipated to be located in the exposed region of the protein, increasing the likelihood of interactions with host or viral protein binding partners, which may either facilitate in virus replication or help in evading the host immune response.
Conclusion: The results of this study emphasize the potential role of the identified mutation in influencing the SH protein function of the genotype C strains. This particular mutation requires additional exploration for the development of novel antivirals aimed at addressing the disease in future.
{"title":"Molecular characterization of Mumps virus circulating in Odisha in 2024.","authors":"Prabhudutta Mamidi, Sailendra Panda, Amrita Ray, Diksha Mohapatra, Madhab Charan Mandal, Debashis Santra, Ketan Kumar, Bhagirathi Dwibedi, Anupam Dey, Soma Chattopadhyay, Baijayantimala Mishra","doi":"10.1016/j.ijmmb.2025.100949","DOIUrl":"10.1016/j.ijmmb.2025.100949","url":null,"abstract":"<p><strong>Purpose: </strong>Recent years have witnessed a notable rise in mumps cases globally, despite the availability of vaccination. This study aims to identify the consistent mutations in mumps virus strains isolated from Odisha in 2024, which may have contributed to the increased transmission of mumps in the country.</p><p><strong>Methods: </strong>A study was conducted involving 32 mumps patients aged 0-45 years who visited a tertiary care hospital in Eastern India. All oropharyngeal swab samples collected from patients underwent RNA extraction, followed by cDNA synthesis. Thereafter, the viral SH gene underwent PCR amplification, and the positive samples were processed for sequencing. A phylogenetic tree was constructed utilizing the MEGA software for identification of viral genotype. Moreover, the current viral SH gene sequences underwent alignment with global sequences utilizing the Clustal W tool for mutational analysis. An in-silico analysis has also been conducted to elucidate the functional implications of any consistent mutation.</p><p><strong>Results: </strong>All current mumps isolates are classified under genotype C and formed a unique cluster within the phylogenetic tree. Moreover, the entire SH protein sequence was conserved across all global genotype C strains, with the notable exception of the Y44S substitution. Additionally, the in-silico analysis revealed that the above mutation may alter the flexibility of the secondary structure of the SH protein. Furthermore, this mutation is anticipated to be located in the exposed region of the protein, increasing the likelihood of interactions with host or viral protein binding partners, which may either facilitate in virus replication or help in evading the host immune response.</p><p><strong>Conclusion: </strong>The results of this study emphasize the potential role of the identified mutation in influencing the SH protein function of the genotype C strains. This particular mutation requires additional exploration for the development of novel antivirals aimed at addressing the disease in future.</p>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":" ","pages":"100949"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775313","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}
Antimicrobial resistance (AMR) is a mounting global health problem underlining the need for an effective antimicrobial stewardship program (AMSP). Cascade reporting holds a major role in AMSP. The recent introduction of a tier system for cascade reporting in CLSI 2023 suggests restricted reporting for second-line or broader-spectrum antimicrobial agents.
Methods
In this pilot study, Tier 1 and Tier 2 antibiotics were identified for different groups of uropathogens based on available antibiogram data. Uropathogens with significant bacteriuria were identified over a period of 10 months (March–December, 2023) and their antimicrobial susceptibility testing (AST) pattern was analyzed as per the tier system.
Results
Cascade reporting was done in 10.6 % of samples with significant bacteriuria and a majority of these isolates belonged to the in-patient department (IPD) with high susceptibility to four different classes of antibiotics in Tier 1.
Conclusion
This study emphasizes the scope of cascade reporting in antimicrobial stewardship at a tertiary healthcare center in India.
{"title":"Applicability of cascade reporting among the uropathogens from a tertiary healthcare center: A pilot study targeting antimicrobial stewardship intervention","authors":"Maitrayee Narayan, Sarita Mohapatra, Bimal Kumar Das, Hitender Gautam, Seema Sood, Benu Dhawan","doi":"10.1016/j.ijmmb.2025.100921","DOIUrl":"10.1016/j.ijmmb.2025.100921","url":null,"abstract":"<div><h3>Introduction</h3><div>Antimicrobial resistance (AMR) is a mounting global health problem underlining the need for an effective antimicrobial stewardship program (AMSP). Cascade reporting holds a major role in AMSP. The recent introduction of a tier system for cascade reporting in CLSI 2023 suggests restricted reporting for second-line or broader-spectrum antimicrobial agents.</div></div><div><h3>Methods</h3><div>In this pilot study, Tier 1 and Tier 2 antibiotics were identified for different groups of uropathogens based on available antibiogram data. Uropathogens with significant bacteriuria were identified over a period of 10 months (March–December, 2023) and their antimicrobial susceptibility testing (AST) pattern was analyzed as per the tier system.</div></div><div><h3>Results</h3><div>Cascade reporting was done in 10.6 % of samples with significant bacteriuria and a majority of these isolates belonged to the in-patient department (IPD) with high susceptibility to four different classes of antibiotics in Tier 1.</div></div><div><h3>Conclusion</h3><div>This study emphasizes the scope of cascade reporting in antimicrobial stewardship at a tertiary healthcare center in India.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"57 ","pages":"Article 100921"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617399","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 : 2025-09-01Epub Date: 2025-07-09DOI: 10.1016/j.ijmmb.2025.100916
Kevin Joseph R , Rohit Chawla , Sumeet Singla , Sonal Saxena
Purpose
To determine the frequency and clinico-epidemiological profile of patients with scrub typhus and to assess the performance characteristics of an ICT based rapid assay for its diagnosis.
Methods
This was an observational cross-sectional study conducted on 175 adults ≥18 years of age presenting with acute onset of fever (temperature >38 °C) for <14 days with any of the following features: eschar, rash, lymphadenopathy, hepatosplenomegaly, jaundice and multi-organ involvement. Immunocompromised patients, such as those with HIV/AIDS, malignancy, patients on cytotoxic drugs and on systemic corticosteroid therapy were excluded from the study. Cases were recruited from medicine wards of Lok Nayak Hospital. Serum from the cases was tested for Orientia tsutsugamushi specific IgM antibody by ELISA and rapid assay. The performance characteristics of rapid assay was evaluated by comparing it with ELISA as the reference standard.
Results
Out of 175 cases, 36 (20.6 %) were reactive for scrub typhus IgM ELISA, while 139 (79.4 %) were non-reactive. Maximum number of scrub typhus cases were in the age group of 21–30 years (41.7 %) with both genders affected equally. Majority of the scrub typhus cases resided in urban areas (69.4 %), belonged to lower middle class (38.9 %) and were seen between the monsoon months of July and October (75 %). Eschar, lymphadenopathy, jaundice, ascites, ARDS, myocarditis, DIC, raised LDH, raised ALP, hyperbilirubinemia, hyperphosphatemia, hypoalbuminemia and leucocytosis were found to be significantly associated with scrub typhus. The sensitivity and specificity of the scrub typhus IgM rapid assay when compared to IgM ELISA was 22.2 % and 100.0 %, respectively, with low kappa value of 0.312.
Conclusion
The frequency of scrub typhus in AFI was found to be 20.6 %. In view of the poor sensitivity, the RDT used in our study cannot be recommended as the screening assay for serodiagnosis of scrub typhus.
{"title":"CLINICO-LABORATORY profile of scrub typhus cases among adults presenting with acute febrile illness","authors":"Kevin Joseph R , Rohit Chawla , Sumeet Singla , Sonal Saxena","doi":"10.1016/j.ijmmb.2025.100916","DOIUrl":"10.1016/j.ijmmb.2025.100916","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the frequency and clinico-epidemiological profile of patients with scrub typhus and to assess the performance characteristics of an ICT based rapid assay for its diagnosis.</div></div><div><h3>Methods</h3><div>This was an observational cross-sectional study conducted on 175 adults ≥18 years of age presenting with acute onset of fever (temperature >38 °C) for <14 days with any of the following features: eschar, rash, lymphadenopathy, hepatosplenomegaly, jaundice and multi-organ involvement. Immunocompromised patients, such as those with HIV/AIDS, malignancy, patients on cytotoxic drugs and on systemic corticosteroid therapy were excluded from the study. Cases were recruited from medicine wards of Lok Nayak Hospital. Serum from the cases was tested for <em>Orientia tsutsugamushi</em> specific IgM antibody by ELISA and rapid assay. The performance characteristics of rapid assay was evaluated by comparing it with ELISA as the reference standard.</div></div><div><h3>Results</h3><div>Out of 175 cases, 36 (20.6 %) were reactive for scrub typhus IgM ELISA, while 139 (79.4 %) were non-reactive. Maximum number of scrub typhus cases were in the age group of 21–30 years (41.7 %) with both genders affected equally. Majority of the scrub typhus cases resided in urban areas (69.4 %), belonged to lower middle class (38.9 %) and were seen between the monsoon months of July and October (75 %). Eschar, lymphadenopathy, jaundice, ascites, ARDS, myocarditis, DIC, raised LDH, raised ALP, hyperbilirubinemia, hyperphosphatemia, hypoalbuminemia and leucocytosis were found to be significantly associated with scrub typhus. The sensitivity and specificity of the scrub typhus IgM rapid assay when compared to IgM ELISA was 22.2 % and 100.0 %, respectively, with low kappa value of 0.312.</div></div><div><h3>Conclusion</h3><div>The frequency of scrub typhus in AFI was found to be 20.6 %. In view of the poor sensitivity, the RDT used in our study cannot be recommended as the screening assay for serodiagnosis of scrub typhus.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"57 ","pages":"Article 100916"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596094","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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