Pub Date : 2025-12-18DOI: 10.1016/j.ijmmb.2025.101041
K. Kirubanandan, Rosemol Varghese, Binesh Lal Y, Ayyanraj Neeravi, Subbulakshmi R, Balaji Veeraraghavan
Streptococcus dysgalactiae subsp
equisimilis (SDSE) is an emerging pathogen with similarities to S. pyogenes, with limited Indian molecular epidemiological data. This study characterized 55 SDSE isolates via MALDI-TOF and whole genome sequencing for emm typing, MLST, virulence, and antimicrobial resistance profiling. Infections mainly affected diabetic males (mean age 44), commonly presenting as cellulitis or non-healing ulcers. sixteen emm types and 17 STs were identified; with all isolates carrying virulence genes lmb, slo, sagA. The isolates were 100 % penicillin susceptible and 42 % macrolide non susceptible with 53 % mef(A) and 35 % msr(D). Findings stress the need for region-specific genomic surveillance.
{"title":"Clinical and genotypic spectrum of SDSE from a tertiary Indian centre: Diversity, virulence, and AMR trends","authors":"K. Kirubanandan, Rosemol Varghese, Binesh Lal Y, Ayyanraj Neeravi, Subbulakshmi R, Balaji Veeraraghavan","doi":"10.1016/j.ijmmb.2025.101041","DOIUrl":"10.1016/j.ijmmb.2025.101041","url":null,"abstract":"<div><h3><em>Streptococcus dysgalactiae</em> subsp</h3><div><em>equisimilis</em> (SDSE) is an emerging pathogen with similarities to <em>S. pyogenes</em>, with limited Indian molecular epidemiological data. This study characterized 55 SDSE isolates via MALDI-TOF and whole genome sequencing for <em>emm</em> typing, MLST, virulence, and antimicrobial resistance profiling. Infections mainly affected diabetic males (mean age 44), commonly presenting as cellulitis or non-healing ulcers. sixteen <em>emm</em> types and 17 STs were identified; with all isolates carrying virulence genes <em>lmb</em>, <em>slo</em>, <em>sagA</em>. The isolates were 100 % penicillin susceptible and 42 % macrolide non susceptible with 53 % <em>mef(A)</em> and 35 % <em>msr(D).</em> Findings stress the need for region-specific genomic surveillance.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101041"},"PeriodicalIF":1.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145786865","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 : 2025-12-15DOI: 10.1016/j.ijmmb.2025.101040
K. Dhanalakshmi, S. Balasubramanian, N. Vignesh, S. Mahalakshmi, Sulochana Putili Bai
Scarlet fever, caused by Group A Streptococcus [Streptococcus pyogenes], presents with a characteristic red rash, fever, and pharyngitis. It predominantly affects children aged 5–15 years, although individuals of any age can be affected. Transmission occurs via respiratory droplets and direct contact with contaminated surfaces or infected individuals. This study emphasizes the utility of rapid antigen detection tests [RADT] as point-of-care diagnostics for scarlet fever, particularly in the context of the recent rise in cases in India. Early diagnosis and initiation of appropriate antibiotic therapy are critical to preventing complications such as acute rheumatic fever and renal involvement.
{"title":"Scarlet fever - A retrospective case series in the midst of recent upsurge of cases in India","authors":"K. Dhanalakshmi, S. Balasubramanian, N. Vignesh, S. Mahalakshmi, Sulochana Putili Bai","doi":"10.1016/j.ijmmb.2025.101040","DOIUrl":"10.1016/j.ijmmb.2025.101040","url":null,"abstract":"<div><div>Scarlet fever, caused by <em>Group A Streptococcus</em> [<em>Streptococcus pyogenes</em>], presents with a characteristic red rash, fever, and pharyngitis. It predominantly affects children aged 5–15 years, although individuals of any age can be affected. Transmission occurs via respiratory droplets and direct contact with contaminated surfaces or infected individuals. This study emphasizes the utility of rapid antigen detection tests [RADT] as point-of-care diagnostics for scarlet fever, particularly in the context of the recent rise in cases in India. Early diagnosis and initiation of appropriate antibiotic therapy are critical to preventing complications such as acute rheumatic fever and renal involvement.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101040"},"PeriodicalIF":1.3,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774205","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}
Present case describes an apparently healthy adult who developed severe Pneumocystis jirovecii pneumonia (PJP) leading to multiple organ dysfunction syndrome. The patient presented with month-long fever, fatiguability and recent onset dyspnoea, subsequently developing acute respiratory distress syndrome (ARDS), acute kidney injury and haematological complications. Definitive diagnosis was made through microscopic examination of P.jirovecii cysts stained by Grocott Gomori Methenamine Silver (GMS) and positive PCR assay of broncho-alveolar lavage fluid. This case highlights the evolving spectrum of PJP manifestations and emphasizes the need for early diagnosis and appropriate management in apparently immunocompetent hosts.
{"title":"Fulminant Pneumocystis jirovecii pneumonia presenting as multi-organ dysfunction syndrome in an immunocompetent host","authors":"Debasish Biswal , Arupparna Sengupta , Mohit Sharma , Bijay Ranjan Mirdha , Aayush Chawla , Rohit Kumar Garg , Sadia Khan , Anubhav Pandey , Sharmila Sengupta","doi":"10.1016/j.ijmmb.2025.101037","DOIUrl":"10.1016/j.ijmmb.2025.101037","url":null,"abstract":"<div><div>Present case describes an apparently healthy adult who developed severe <em>Pneumocystis jirovecii</em> pneumonia (PJP) leading to multiple organ dysfunction syndrome. The patient presented with month-long fever, fatiguability and recent onset dyspnoea, subsequently developing acute respiratory distress syndrome (ARDS), acute kidney injury and haematological complications. Definitive diagnosis was made through microscopic examination of <em>P.jirovecii</em> cysts stained by Grocott Gomori Methenamine Silver (GMS) and positive PCR assay of broncho-alveolar lavage fluid. This case highlights the evolving spectrum of PJP manifestations and emphasizes the need for early diagnosis and appropriate management in apparently immunocompetent hosts.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101037"},"PeriodicalIF":1.3,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145732941","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 : 2025-12-09DOI: 10.1016/j.ijmmb.2025.101035
Emrah Salman
Background
The primary reason for increased lab use is inappropriate or needless test requests. Our study examined the benefits of repeated antinuclear antibody (ANA) testing and the reasons for ANA test requests in accordance with reasonable test selection and inappropriate scenarios.
Methods
We examined 2.5 years of data from a Turkish tertiary hospital in this retrospective cohort analysis. ANA and other autoimmune test data and clinical information of all patients whose ANA result changed from negative to positive on repeat testing were gathered from the hospital record system.
Results
44,341 individuals had 51,959 ANA tests between February 2019 and June 2021. ANA tests were positive in 7551 (17 %) of 44,341 patients and 9303 (17.9 %) of 51,959 tests. On 14.6 % (7618 out of 51,959) of tests requested and 13.2 % (5891 out of 44,341) of patients, repeat tests were performed. Of the 5891 patients retested, 171 were initially negative but later positive. A minority (3.7 %) of initially negative ANA patients experienced a change to a titer of ≥1:100 in our 2.5-year investigation. A novel ANA associated rheumatic disease (AARD) was detected in 17 patients. The new positive ANA test had a positive predictive value of 15.1 % following an initially negative ANA test.
Conclusions
It is common to repeat ANA testing. ANA tests that yielded negative results in the beginning frequently repeat without change. Repetition had no effect on clinical prediction of AARD. Repeat ANA testing in hospital patients is ineffective rather than useful.
{"title":"Rational test selection in immunology laboratory: Investigating the utility of repeated antinuclear antibody tests","authors":"Emrah Salman","doi":"10.1016/j.ijmmb.2025.101035","DOIUrl":"10.1016/j.ijmmb.2025.101035","url":null,"abstract":"<div><h3>Background</h3><div>The primary reason for increased lab use is inappropriate or needless test requests. Our study examined the benefits of repeated antinuclear antibody (ANA) testing and the reasons for ANA test requests in accordance with reasonable test selection and inappropriate scenarios.</div></div><div><h3>Methods</h3><div>We examined 2.5 years of data from a Turkish tertiary hospital in this retrospective cohort analysis. ANA and other autoimmune test data and clinical information of all patients whose ANA result changed from negative to positive on repeat testing were gathered from the hospital record system.</div></div><div><h3>Results</h3><div>44,341 individuals had 51,959 ANA tests between February 2019 and June 2021. ANA tests were positive in 7551 (17 %) of 44,341 patients and 9303 (17.9 %) of 51,959 tests. On 14.6 % (7618 out of 51,959) of tests requested and 13.2 % (5891 out of 44,341) of patients, repeat tests were performed. Of the 5891 patients retested, 171 were initially negative but later positive. A minority (3.7 %) of initially negative ANA patients experienced a change to a titer of ≥1:100 in our 2.5-year investigation. A novel ANA associated rheumatic disease (AARD) was detected in 17 patients. The new positive ANA test had a positive predictive value of 15.1 % following an initially negative ANA test.</div></div><div><h3>Conclusions</h3><div>It is common to repeat ANA testing. ANA tests that yielded negative results in the beginning frequently repeat without change. Repetition had no effect on clinical prediction of AARD. Repeat ANA testing in hospital patients is ineffective rather than useful.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101035"},"PeriodicalIF":1.3,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145732942","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}
Elizabethkingia meningoseptica is an emerging nosocomial pathogen with complex antimicrobial resistance. We conducted a retrospective study in intensive care units (August 2022–December 2024) involving thirteen patients (ten adults, three paediatric). Universal resistance to piperacillin/tazobactam, aminoglycosides but susceptibility to minocycline was observed. Environmental sampling revealed contamination in water outlets and sink holes. Whole genome sequencing demonstrated clonal relationships between clinical and environmental isolates, confirming nosocomial transmission. Neurological complications were significantly associated with mortality. Following targeted interventions including enhanced disinfection and thermal water flushing, no new cases occurred during three-month follow-up. This study highlights environmental surveillance and integrated infection control importance.
{"title":"Emergence and clonal transmission of Elizabethkingia meningoseptica in adult and paediatric intensive care units: An integrated clinical, microbiological, and genomic analysis","authors":"Debasish Biswal , Sharmila Sengupta , Ripenmeet Salhotra , Pankhuri Kumari , Maninder Dhaliwal , Sadia Khan , Aayush Chawla , Veena Raghunathan , Sandeep Mangla","doi":"10.1016/j.ijmmb.2025.101032","DOIUrl":"10.1016/j.ijmmb.2025.101032","url":null,"abstract":"<div><div><em>Elizabethkingia meningoseptica</em> is an emerging nosocomial pathogen with complex antimicrobial resistance. We conducted a retrospective study in intensive care units (August 2022–December 2024) involving thirteen patients (ten adults, three paediatric). Universal resistance to piperacillin/tazobactam, aminoglycosides but susceptibility to minocycline was observed. Environmental sampling revealed contamination in water outlets and sink holes. Whole genome sequencing demonstrated clonal relationships between clinical and environmental isolates, confirming nosocomial transmission. Neurological complications were significantly associated with mortality. Following targeted interventions including enhanced disinfection and thermal water flushing, no new cases occurred during three-month follow-up. This study highlights environmental surveillance and integrated infection control importance.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101032"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668261","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 : 2025-11-28DOI: 10.1016/j.ijmmb.2025.101033
G. Vithiya , V. Mangayarkarasi
We report an outbreak of Burkholderia cepacia bacteremia in a cardiothoracic surgery intensive care unit. Four cases of bloodstream infections were reported between August 16, 2024 and August 31, 2024. Microbiological surveillance of clean and sterile material from the unit revealed growth of B. cepacia from opened and sealed ultrasound gel bottles. Further cultures acquired from ultrasound gel containers from other units also grew B. cepacia and hence displaced by single use sterile gel. The outbreak was regarded terminated by the first week of September 2024 as no additional cases were described.
{"title":"Outbreak of Burkholderia cepacia bacteremia consequent to contaminated ultrasound gel-a report from a tertiary care centre in South Tamilnadu, India","authors":"G. Vithiya , V. Mangayarkarasi","doi":"10.1016/j.ijmmb.2025.101033","DOIUrl":"10.1016/j.ijmmb.2025.101033","url":null,"abstract":"<div><div>We report an outbreak of <em>Burkholderia cepacia</em> bacteremia in a cardiothoracic surgery intensive care unit. Four cases of bloodstream infections were reported between August 16, 2024 and August 31, 2024. Microbiological surveillance of clean and sterile material from the unit revealed growth of <em>B. cepacia</em> from opened and sealed ultrasound gel bottles. Further cultures acquired from ultrasound gel containers from other units also grew <em>B. cepacia</em> and hence displaced by single use sterile gel. The outbreak was regarded terminated by the first week of September 2024 as no additional cases were described.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101033"},"PeriodicalIF":1.3,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648423","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}
Sterile pyuria poses a diagnostic challenge due to varied aetiologies. Atypical pathogens including Chlamydia trachomatis and genital mycoplasmas are considered etiological agents but are under-reported, especially in resource-limited settings. This study determined the prevalence of these atypical pathogens in sterile pyuria patients.
Materials and methods
This 4-year prospective observational study screened 640 adults admitted to Medicine wards of a tertiary care hospital for sterile pyuria, defined as urine microscopy showing >10 WBCs/HPF with no bacterial growth on culture. All sterile pyuria patients were evaluated for Chlamydia trachomatis (CT), Ureaplasma spp., Mycoplasma hominis (MH) and Mycoplasma genitalium (MG) from first void urine samples. Mycoplasma hominis and Ureaplasma spp. were detected by culture and PCR assay. Chlamydia trachomatis was detected by PCR assay. Mycoplasma genitalium was detected by Real-time PCR assay. Additional assessments for other potential causes were carried out. Patients were treated with doxycycline or azithromycin and followed for outcomes. Risk factors for infection with these atypical agents were explored.
Results
Of 640 patients screened, 100 (15.6 %) had sterile pyuria. Atypical pathogens were detected in 40 %. CT, Ureaplasma spp., and MH were detected in 19 %, 15 % and 5 % respectively. One patient tested positive for MG. Multivariate logistic regression identified multiple sexual partners (adjusted OR 12.01, 95 % CI 2.07–69.40, p = 0.005) and past pelvic surgery (adjusted OR 5.64, 95 % CI 1.43–22.24, p = 0.013) as risk factors. Twenty-five (62.5 %) of 40 patients achieved complete clinical and microbiological cure with treatment. Laboratory records revealed genitourinary tuberculosis in 2 patients.
Conclusion
This study identified 40 % prevalence of atypical pathogens in sterile pyuria patients. Unlike previous assumptions, genitourinary tuberculosis was not a common cause in our population. Our findings emphasize the necessity for comprehensive screening for CT, Ureaplasma spp., MH, and MG in sterile pyuria patients.
无菌脓尿由于病因多样，给诊断带来了挑战。包括沙眼衣原体和生殖器支原体在内的非典型病原体被认为是病原体，但报告不足，特别是在资源有限的情况下。本研究确定了无菌脓尿患者中这些非典型病原体的患病率。材料和方法这项为期4年的前瞻性观察研究筛选了一家三级医院内科病房收治的640名无菌脓尿症成年人，定义为尿液显微镜显示10个白细胞/HPF，培养物上没有细菌生长。对所有无菌脓尿患者进行首次空尿沙眼衣原体（CT）、脲原体、人支原体（MH）和生殖支原体（MG）检测。用培养法和PCR法检测人支原体和脲原体。PCR检测沙眼衣原体。采用Real-time PCR法检测生殖支原体。对其他潜在原因进行了进一步评估。患者接受强力霉素或阿奇霉素治疗并随访结果。探讨了感染这些非典型病原体的危险因素。结果640例患者中，无菌脓尿100例（15.6%）。非典型病原体检出率为40%。CT、脲原体和MH检出率分别为19%、15%和5%。一名患者MG检测呈阳性。多因素logistic回归发现多个性伴侣（校正OR 12.01, 95% CI 2.07-69.40, p = 0.005）和既往盆腔手术（校正OR 5.64, 95% CI 1.43-22.24, p = 0.013）是危险因素。经治疗，40例患者中25例（62.5%）达到临床和微生物学完全治愈。实验室记录显示2例泌尿生殖系统结核。结论无菌性脓尿患者中非典型病原体的患病率为40%。与以前的假设不同，泌尿生殖系统结核病在我们的人群中并不常见。我们的研究结果强调了对无菌脓尿患者进行CT、脲原体、MH和MG综合筛查的必要性。
{"title":"Prevalence of Chlamydia trachomatis, Ureaplasma spp., Mycoplasma hominis and Mycoplasma genitalium in patients with sterile pyuria","authors":"Anivita Aggarwal , Debasish Biswal , Jyoti Rawre , Naval Vikram , Naveet Wig , Manish Soneja , Sreenivas Vishnubhatla , Benu Dhawan","doi":"10.1016/j.ijmmb.2025.101030","DOIUrl":"10.1016/j.ijmmb.2025.101030","url":null,"abstract":"<div><h3>Introduction</h3><div>Sterile pyuria poses a diagnostic challenge due to varied aetiologies. Atypical pathogens including <em>Chlamydia trachomatis</em> and genital mycoplasmas are considered etiological agents but are under-reported, especially in resource-limited settings. This study determined the prevalence of these atypical pathogens in sterile pyuria patients.</div></div><div><h3>Materials and methods</h3><div>This 4-year prospective observational study screened 640 adults admitted to Medicine wards of a tertiary care hospital for sterile pyuria, defined as urine microscopy showing >10 WBCs/HPF with no bacterial growth on culture. All sterile pyuria patients were evaluated for <em>Chlamydia trachomatis</em> (CT), <em>Ureaplasma</em> spp., <em>Mycoplasma hominis</em> (MH) and <em>Mycoplasma genitalium</em> (MG) from first void urine samples. <em>Mycoplasma hominis</em> and <em>Ureaplasma</em> spp. were detected by culture and PCR assay. <em>Chlamydia trachomatis</em> was detected by PCR assay. <em>Mycoplasma genitalium</em> was detected by Real-time PCR assay. Additional assessments for other potential causes were carried out. Patients were treated with doxycycline or azithromycin and followed for outcomes. Risk factors for infection with these atypical agents were explored.</div></div><div><h3>Results</h3><div>Of 640 patients screened, 100 (15.6 %) had sterile pyuria. Atypical pathogens were detected in 40 %. CT, <em>Ureaplasma</em> spp., and MH were detected in 19 %, 15 % and 5 % respectively. One patient tested positive for MG. Multivariate logistic regression identified multiple sexual partners (adjusted OR 12.01, 95 % CI 2.07–69.40, p = 0.005) and past pelvic surgery (adjusted OR 5.64, 95 % CI 1.43–22.24, p = 0.013) as risk factors. Twenty-five (62.5 %) of 40 patients achieved complete clinical and microbiological cure with treatment. Laboratory records revealed genitourinary tuberculosis in 2 patients.</div></div><div><h3>Conclusion</h3><div>This study identified 40 % prevalence of atypical pathogens in sterile pyuria patients. Unlike previous assumptions, genitourinary tuberculosis was not a common cause in our population. Our findings emphasize the necessity for comprehensive screening for CT, <em>Ureaplasma</em> spp., MH, and MG in sterile pyuria patients.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101030"},"PeriodicalIF":1.3,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621857","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 : 2025-11-25DOI: 10.1016/j.ijmmb.2025.101029
Aditi Gupta , Nithya S. Roy , Vibhor Tak , Manish Chaturvedy
Catheter related bloodstream infections are a common concern in hospitalized and immunocompromised patients. We report a case of CKD with an indwelling left IJV Permacath who developed fever and chills during dialysis. Investigations showed leukocytosis, elevated CRP (75 mg/L), and procalcitonin (9.1 ng/mL). Paired blood cultures grew Kocuria rhizophila, identified by MALDI-TOF, with a two-hour difference in positivity indicating CRBSI. Vancomycin led to improvement and antibiotic lock therapy was initiated. This case highlights that rare organisms such as K. rhizophila can be true pathogens in dialysis patients, and correct identification with MALDI-TOF alongside clinical correlation is crucial for appropriate management.
{"title":"Catheter-related bloodstream infection by Kocuria rhizophila in a dialysis patient","authors":"Aditi Gupta , Nithya S. Roy , Vibhor Tak , Manish Chaturvedy","doi":"10.1016/j.ijmmb.2025.101029","DOIUrl":"10.1016/j.ijmmb.2025.101029","url":null,"abstract":"<div><div>Catheter related bloodstream infections are a common concern in hospitalized and immunocompromised patients. We report a case of CKD with an indwelling left IJV Permacath who developed fever and chills during dialysis. Investigations showed leukocytosis, elevated CRP (75 mg/L), and procalcitonin (9.1 ng/mL). Paired blood cultures grew <em>Kocuria rhizophila</em>, identified by MALDI-TOF, with a two-hour difference in positivity indicating CRBSI. Vancomycin led to improvement and antibiotic lock therapy was initiated. This case highlights that rare organisms such as <em>K. rhizophila</em> can be true pathogens in dialysis patients, and correct identification with MALDI-TOF alongside clinical correlation is crucial for appropriate management.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101029"},"PeriodicalIF":1.3,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621856","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 : 2025-11-24DOI: 10.1016/j.ijmmb.2025.101031
Fengyuan He , Limin Mei , Linzi Zeng
Introduction
Pertussis is an acute respiratory disease primarily caused by Bordetella pertussis, and its incidence has shown a resurgence. Polymerase chain reaction (PCR) is a recognized molecular detection method, and various related detection methods have emerged.
Methods
This study is performed according to the PRISMA checklist. Relevant literature is adopted from the online databases. The quality of the included studies is assessed based on the REVMAN software (version 5.4). Statistical analysis is performed by STATA 14.0 and Meta-DiSc 1.4 software.
Results
The results of this meta-analysis show that four different PCR techniques—conventional PCR, real-time quantitative PCR (Q-PCR), multiplex PCR, and nested PCR—have a pooled sensitivity of 0.95 (95 % CI: 0.93–0.97), pooled specificity of 0.93 (95 % CI: 0.89–0.95), pooled positive likelihood ratio (PLR) of 12.22 (95 % CI: 8.62–17.33), pooled negative likelihood ratio (NLR) of 0.05 (95 % CI: 0.03–0.08), and pooled diagnostic odds ratio (DOR) of 244.88 (95 % CI: 133.34–449.72). Multiplex PCR has the highest pooled specificity, PLR, and DOR. Nested PCR has the highest sensitivity and the lowest NLR. PCR testing holds significant value in the early diagnosis of pertussis. Multiplex PCR, nested PCR, and Q-PCR outperform conventional PCR in diagnostic performance.
Conclusions
Each type of PCR test has its advantages and disadvantages, and clinical selection should consider factors such as testing purpose, personnel, and conditions.
{"title":"Meta-analysis of the diagnostic value of polymerase chain reaction-based nucleic acid detection methods for pertussis","authors":"Fengyuan He , Limin Mei , Linzi Zeng","doi":"10.1016/j.ijmmb.2025.101031","DOIUrl":"10.1016/j.ijmmb.2025.101031","url":null,"abstract":"<div><h3>Introduction</h3><div>Pertussis is an acute respiratory disease primarily caused by <em>Bordetella pertussis</em>, and its incidence has shown a resurgence. Polymerase chain reaction (PCR) is a recognized molecular detection method, and various related detection methods have emerged.</div></div><div><h3>Methods</h3><div>This study is performed according to the PRISMA checklist. Relevant literature is adopted from the online databases. The quality of the included studies is assessed based on the REVMAN software (version 5.4). Statistical analysis is performed by STATA 14.0 and Meta-DiSc 1.4 software.</div></div><div><h3>Results</h3><div>The results of this meta-analysis show that four different PCR techniques—conventional PCR, real-time quantitative PCR (Q-PCR), multiplex PCR, and nested PCR—have a pooled sensitivity of 0.95 (95 % CI: 0.93–0.97), pooled specificity of 0.93 (95 % CI: 0.89–0.95), pooled positive likelihood ratio (PLR) of 12.22 (95 % CI: 8.62–17.33), pooled negative likelihood ratio (NLR) of 0.05 (95 % CI: 0.03–0.08), and pooled diagnostic odds ratio (DOR) of 244.88 (95 % CI: 133.34–449.72). Multiplex PCR has the highest pooled specificity, PLR, and DOR. Nested PCR has the highest sensitivity and the lowest NLR. PCR testing holds significant value in the early diagnosis of pertussis. Multiplex PCR, nested PCR, and Q-PCR outperform conventional PCR in diagnostic performance.</div></div><div><h3>Conclusions</h3><div>Each type of PCR test has its advantages and disadvantages, and clinical selection should consider factors such as testing purpose, personnel, and conditions.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101031"},"PeriodicalIF":1.3,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621855","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}
Escherichia coli is a major pathogen in bloodstream infections (BSIs), with increasing concern over antimicrobial resistance (AMR) and the evolving pathogenic potential of phylogroups traditionally considered commensal. This study investigates the genetic characteristics of E. coli isolates causing BSIs in India, with a focus on phylogroups A to F.
Methods
204 E. coli bloodstream isolates received at a tertiary hospital in India were whole genome sequenced. Phylogroups, sequence types (STs), antimicrobial resistance genes (ARGs), virulence factors (VFs), and plasmid replicon types were determined. Bioinformatics analyses include MLST, ResFinder, VirulenceFinder, PlasmidFinder, and ClermonTyping for phylogroup assignment.
Results
Phylogroup B2 (35 %) was the most prevalent, followed by phylogroup A (32 %) and D (19 %). ST131 (B2) emerged as the dominant clone (22 %). Phylogroup A isolates, previously considered commensal and primarily associated with high AMR, now demonstrated notable acquisition of virulence factors such as fimH and iutA, indicating an emerging role as significant BSI pathogens. These isolates also showed high clonal diversity (e.g., ST167, ST410, ST617). Key resistance genes included blaCTX-M (53 %) and blaTEM (25 %), frequently associated with IncF plasmids. Multi-replicon plasmid profiles, particularly IncF variants, were significantly associated with co-carriage of both AMR and VF genes, contributing to enhanced pathogenicity.
Conclusion
This study highlights the emerging role of phylogroup A E. coli, traditionally commensal and AMR-rich as a leading cause of BSIs in India following the acquisition of virulence factors. In parallel, B2 clones like ST131 continue to drive infections through their established virulence and resistance repertoire. Such multi-replicon IncF plasmids driving AMR–VF co-selection, calls for focused surveillance and intervention in E. coli BSIs.
{"title":"Genetic plasticity of Escherichia coli causing bloodstream infections in India: A focus on phylogroups A to F","authors":"Karthik Gunasekaran , Irulappan Madhumathi , Santhosh Raj , Greesma Grace Thomas , Venkatesh Narashiman , Vishnukumar Ramesh , Subbulakshmi Rajendran , Ramprakash Rayala , Ayyanraj Neeravi , Binesh Lal , Kamini Walia , Balaji Veeraraghavan","doi":"10.1016/j.ijmmb.2025.101026","DOIUrl":"10.1016/j.ijmmb.2025.101026","url":null,"abstract":"<div><h3>Background</h3><div><em>Escherichia coli</em> is a major pathogen in bloodstream infections (BSIs), with increasing concern over antimicrobial resistance (AMR) and the evolving pathogenic potential of phylogroups traditionally considered commensal. This study investigates the genetic characteristics of <em>E. coli</em> isolates causing BSIs in India, with a focus on phylogroups A to F.</div></div><div><h3>Methods</h3><div>204 <em>E. coli</em> bloodstream isolates received at a tertiary hospital in India were whole genome sequenced. Phylogroups, sequence types (STs), antimicrobial resistance genes (ARGs), virulence factors (VFs), and plasmid replicon types were determined. Bioinformatics analyses include MLST, ResFinder, VirulenceFinder, PlasmidFinder, and ClermonTyping for phylogroup assignment.</div></div><div><h3>Results</h3><div>Phylogroup B2 (35 %) was the most prevalent, followed by phylogroup A (32 %) and D (19 %). ST131 (B2) emerged as the dominant clone (22 %). Phylogroup A isolates, previously considered commensal and primarily associated with high AMR, now demonstrated notable acquisition of virulence factors such as <em>fimH</em> and <em>iutA</em>, indicating an emerging role as significant BSI pathogens. These isolates also showed high clonal diversity (e.g., ST167, ST410, ST617). Key resistance genes included blaCTX-M (53 %) and blaTEM (25 %), frequently associated with IncF plasmids. Multi-replicon plasmid profiles, particularly IncF variants, were significantly associated with co-carriage of both AMR and VF genes, contributing to enhanced pathogenicity.</div></div><div><h3>Conclusion</h3><div>This study highlights the emerging role of phylogroup A <em>E. coli</em>, traditionally commensal and AMR-rich as a leading cause of BSIs in India following the acquisition of virulence factors. In parallel, B2 clones like ST131 continue to drive infections through their established virulence and resistance repertoire. Such multi-replicon IncF plasmids driving AMR–VF co-selection, calls for focused surveillance and intervention in <em>E. coli</em> BSIs.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101026"},"PeriodicalIF":1.3,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145587295","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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