Pub Date : 2025-09-01Epub Date: 2025-08-05DOI: 10.1016/j.ijmmb.2025.100948
Karthick Nithyanandhan, Shoba Mammen, Priya Abraham
Background: Human papillomaviruses are sexually transmitted viruses that have cutaneous and mucosal tropism. While usually cleared by the immune system, persistent infection can lead to cancer. HPV-related tumours account for 5 % of all cancers and over 30 % of cancers of infectious aetiology. One out of every 13 cancers in India are from HPV-related sites. The role of HPV in cervical cancer is well established, but has also been implicated in non-cervical malignancies including penile, anal, vulvar, vaginal, and head and neck cancers. The prevalence and distribution of HPV-related non-cervical cancers, however, varies globally and remains underreported in countries like India with a paucity of large-scale, population-based studies.
Objectives: A literature search of the PubMed database was conducted using relevant MeSH terms and keywords. The findings aimed to summarize the existing literature on HPV-associated non-cervical cancers in India, the implicated HPV genotypes across anatomical sites, and identify possible research gaps in surveillance, screening, and possible prevention strategies.
Content: In this article, we have reviewed Indian studies against the backdrop of the global scenario, reporting the presence of HPV in non-cervical cancers and high-risk populations. Findings revealed considerable HPV prevalence in non-cervical malignancies in India: 42.5 % in penile cancers, 52.2 % in anal cancers, 22.8-44.8 % in oropharyngeal cancers, and 7.5-34.1 % in laryngeal cancers. HPV-16 was the predominant genotype identified across most tumours. Additionally, high-risk groups particularly HIV-positive MSMs, exhibited elevated HPV DNA positivity from anal, penile and scrotal sites. Overall, in India, there was a lack of robust, population-based data and standardized diagnostic protocols. The absence of routine HPV testing and screening and the limited implementation of HPV vaccination further compound this public health challenge. Enhanced epidemiological surveillance, screening and vaccination are needed to address the rising burden of HPV-related non-cervical cancers.
{"title":"Human papillomavirus infection in non-cervical sites in India.","authors":"Karthick Nithyanandhan, Shoba Mammen, Priya Abraham","doi":"10.1016/j.ijmmb.2025.100948","DOIUrl":"10.1016/j.ijmmb.2025.100948","url":null,"abstract":"<p><strong>Background: </strong>Human papillomaviruses are sexually transmitted viruses that have cutaneous and mucosal tropism. While usually cleared by the immune system, persistent infection can lead to cancer. HPV-related tumours account for 5 % of all cancers and over 30 % of cancers of infectious aetiology. One out of every 13 cancers in India are from HPV-related sites. The role of HPV in cervical cancer is well established, but has also been implicated in non-cervical malignancies including penile, anal, vulvar, vaginal, and head and neck cancers. The prevalence and distribution of HPV-related non-cervical cancers, however, varies globally and remains underreported in countries like India with a paucity of large-scale, population-based studies.</p><p><strong>Objectives: </strong>A literature search of the PubMed database was conducted using relevant MeSH terms and keywords. The findings aimed to summarize the existing literature on HPV-associated non-cervical cancers in India, the implicated HPV genotypes across anatomical sites, and identify possible research gaps in surveillance, screening, and possible prevention strategies.</p><p><strong>Content: </strong>In this article, we have reviewed Indian studies against the backdrop of the global scenario, reporting the presence of HPV in non-cervical cancers and high-risk populations. Findings revealed considerable HPV prevalence in non-cervical malignancies in India: 42.5 % in penile cancers, 52.2 % in anal cancers, 22.8-44.8 % in oropharyngeal cancers, and 7.5-34.1 % in laryngeal cancers. HPV-16 was the predominant genotype identified across most tumours. Additionally, high-risk groups particularly HIV-positive MSMs, exhibited elevated HPV DNA positivity from anal, penile and scrotal sites. Overall, in India, there was a lack of robust, population-based data and standardized diagnostic protocols. The absence of routine HPV testing and screening and the limited implementation of HPV vaccination further compound this public health challenge. Enhanced epidemiological surveillance, screening and vaccination are needed to address the rising burden of HPV-related non-cervical cancers.</p>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":" ","pages":"100948"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768597","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 : 2025-09-01DOI: 10.1016/S0255-0857(25)00176-8
{"title":"Aims and Scope","authors":"","doi":"10.1016/S0255-0857(25)00176-8","DOIUrl":"10.1016/S0255-0857(25)00176-8","url":null,"abstract":"","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"57 ","pages":"Article 100963"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145216500","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 : 2025-09-01DOI: 10.1016/j.ijmmb.2025.100959
Preethaa Sri P. , Namrata Chhabra , Archana Keche
Purpose
Pemphigus vulgaris (PV) is a chronic immunobullous disorder treated with high doses of immunosuppressants. Oral candidiasis (OC) is the most common opportunistic infection reported in PV. Previous studies have shown variability in species distribution and the emergence of multidrug-resistant Candida species in PV. However, Indian studies to identify the Candida species and their antifungal sensitivity pattern in PV are lacking.
Methods
This was a case-control study, including patients with PV and oral lesions as cases and healthy individuals as controls, and excluding cases with a history of antifungal use within the last two weeks. The oral swabs from cases and controls were processed for fungal culture and antifungal susceptibility testing.
Results
A total of 74 cases and 74 healthy controls were included in the study. 59.40 % (44/74) of the cases were diagnosed with OC. Candida isolates identified from cases were C. albicans (12/74), C. glabrata (3/74), C. parapsilosis (3/74), C. tropicalis (3/74), and C. Krusei (1/74). In contrast, only C. albicans was isolated from controls (4/74). Most of the C. albicans isolates were sensitive to fluconazole, voriconazole (83.33 %, 10/12), amphotericin B (91.67 %, 11/12), and itraconazole. Fluconazole resistance was noted in 50 % (2/4) of the control isolates. Among the non-albicans Candida species, C. parapsilosis and C. tropicalis were found to be sensitive to all antifungals except caspofungin. All C. glabrata isolates were resistant to fluconazole (100 %). The C. krusei isolate was resistant to fluconazole, amphotericin B, caspofungin, and flucytosine.
Limitation
Non-albicans Candida species were isolated only in a small number of cases. This study focuses on the species distribution and sensitivity patterns of Candida in patients with PV only.
Conclusion
This study provides data on OC in PV from an Indian population, highlighting the prevalence of non-albicans Candida species and their resistance patterns. C. albicans was the most common isolate in PV, as well as in controls, showing good susceptibility to antifungals. Among non-albicans Candida species, C. glabrata and C. krusei showed multidrug resistance.
{"title":"Species identification and antifungal susceptibility pattern of oral Candida isolates in pemphigus vulgaris: results from a case-control study","authors":"Preethaa Sri P. , Namrata Chhabra , Archana Keche","doi":"10.1016/j.ijmmb.2025.100959","DOIUrl":"10.1016/j.ijmmb.2025.100959","url":null,"abstract":"<div><h3>Purpose</h3><div>Pemphigus vulgaris (PV) is a chronic immunobullous disorder treated with high doses of immunosuppressants. Oral candidiasis (OC) is the most common opportunistic infection reported in PV. Previous studies have shown variability in species distribution and the emergence of multidrug-resistant <em>Candida</em> species in PV. However, Indian studies to identify the <em>Candida</em> species and their antifungal sensitivity pattern in PV are lacking.</div></div><div><h3>Methods</h3><div>This was a case-control study, including patients with PV and oral lesions as cases and healthy individuals as controls, and excluding cases with a history of antifungal use within the last two weeks. The oral swabs from cases and controls were processed for fungal culture and antifungal susceptibility testing.</div></div><div><h3>Results</h3><div>A total of 74 cases and 74 healthy controls were included in the study. 59.40 % (44/74) of the cases were diagnosed with OC. <em>Candida</em> isolates identified from cases were <em>C. albicans</em> (12/74), <em>C. glabrata</em> (3/74), <em>C. parapsilosis</em> (3/74), <em>C. tropicalis</em> (3/74), <em>and C. Krusei (</em>1/74). In contrast, only C. albicans was isolated from controls (4/74). Most of the <em>C. albicans</em> isolates were sensitive to fluconazole, voriconazole (83.33 %, 10/12), amphotericin B (91.67 %, 11/12), and itraconazole. Fluconazole resistance was noted in 50 % (2/4) of the control isolates. Among the non-albicans <em>Candida</em> species, <em>C. parapsilosis</em> and <em>C. tropicalis</em> were found to be sensitive to all antifungals except caspofungin. All <em>C. glabrata</em> isolates were resistant to fluconazole (100 %). <em>The C. krusei</em> isolate was resistant to fluconazole, amphotericin B, caspofungin, and flucytosine.</div></div><div><h3>Limitation</h3><div>Non-albicans <em>Candida species</em> were isolated only in a small number of cases. This study focuses on the species distribution and sensitivity patterns of <em>Candida</em> in patients with PV only.</div></div><div><h3>Conclusion</h3><div>This study provides data on OC in PV from an Indian population, highlighting the prevalence of non-albicans <em>Candida</em> species and their resistance patterns. <em>C. albicans</em> was the most common isolate in PV, as well as in controls, showing good susceptibility to antifungals. Among non-albicans <em>Candida</em> species, <em>C. glabrata</em> and <em>C. krusei</em> showed multidrug resistance.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"58 ","pages":"Article 100959"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992473","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 study was undertaken to know the epidemiology of various microorganisms causing gastroenteritis in paediatric age group, to evaluate clinico-microbiological correlation with respect to the type of microorganism, to study the clinical presentations and impact of syndromic based film array assay on antimicrobial stewardship and patient management.
Methods
This is five years retrospective study in which the results of Gastrointestinal film array panel of stool specimens of children≤16 Years of age who presented with gastroenteritis during 2019–2023 were noted. Clinical correlation of the microbes was done with respect to suspected clinical diagnosis, age, immune status and other underlying illness.
Results
Out of 151 samples, 41 were negative for all the pathogens and 110 showed presence of one or more pathogens. The occurrence of negative Film array assay in immunocompromised patients was observably more in comparison to immunocompetent patients (36.36 % vs 23.36 %). Rota virus A and Shigella/Enteroinvasive Escherichia coli (EIEC) were statistically (p value≤0.05) more often detected in immunocompetent patients and children below 5 years of age. The detection of Clostridioides difficile toxin A/B was mainly attributed to transient colonization or asymptomatic carriage in young children. Giardia lamblia and Entamoeba histolytica were more often detected in immunocompetent children. Amongst viruses, Norovirus was detected maximally.
Conclusions
Syndromic panel-based detection of pathogens can help in understanding epidemiology of infections, antimicrobial stewardship, setting an example for diagnostic stewardship and may act as a good tool for surveillance of infections thereby leading to timely initiation of preventive strategies.
目的：了解引起儿童年龄组胃肠炎的各种微生物的流行病学，评价微生物类型与临床微生物学的相关性，研究基于综合征的薄膜阵列试验的临床表现及其对抗菌药物管理和患者管理的影响。方法：对儿童粪便标本进行5年的回顾性研究。结果：151个样本中，41个样本的所有病原体均为阴性，110个样本显示存在一种或多种病原体。免疫功能低下患者的Film array阴性发生率明显高于免疫功能正常患者（36.36% vs 23.36%）。结论：基于综合征组的病原体检测有助于了解感染流行病学，抗菌药物管理，为诊断管理树立榜样，并可能作为监测感染的良好工具，从而导致及时启动预防策略。
{"title":"Syndromic panel testing- Understanding epidemiology of paediatric diarrhoea to augment antimicrobial stewardship in tertiary health care set-up","authors":"Hena Butta , Raman Sardana , Anupam Sibal , Leena Mendiratta , Ghanta Naga Sai Snigdha , Smita Malhotra , Yaja Jebaying","doi":"10.1016/j.ijmmb.2025.100956","DOIUrl":"10.1016/j.ijmmb.2025.100956","url":null,"abstract":"<div><h3>Purpose</h3><div>This study was undertaken to know the epidemiology of various microorganisms causing gastroenteritis in paediatric age group, to evaluate clinico-microbiological correlation with respect to the type of microorganism, to study the clinical presentations and impact of syndromic based film array assay on antimicrobial stewardship and patient management.</div></div><div><h3>Methods</h3><div>This is five years retrospective study in which the results of Gastrointestinal film array panel of stool specimens of children≤16 Years of age who presented with gastroenteritis during 2019–2023 were noted. Clinical correlation of the microbes was done with respect to suspected clinical diagnosis, age, immune status and other underlying illness.</div></div><div><h3>Results</h3><div>Out of 151 samples, 41 were negative for all the pathogens and 110 showed presence of one or more pathogens. The occurrence of negative Film array assay in immunocompromised patients was observably more in comparison to immunocompetent patients (36.36 % vs 23.36 %). Rota virus A and <em>Shigella</em>/Enteroinvasive <em>Escherichia coli</em> (EIEC) were statistically (p value≤0.05) more often detected in immunocompetent patients and children below 5 years of age. The detection of <em>Clostridioides difficile</em> toxin A/B was mainly attributed to transient colonization or asymptomatic carriage in young children. <em>Giardia lamblia</em> and <em>Entamoeba histolytica</em> were more often detected in immunocompetent children. Amongst viruses, Norovirus was detected maximally.</div></div><div><h3>Conclusions</h3><div>Syndromic panel-based detection of pathogens can help in understanding epidemiology of infections, antimicrobial stewardship, setting an example for diagnostic stewardship and may act as a good tool for surveillance of infections thereby leading to timely initiation of preventive strategies.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"58 ","pages":"Article 100956"},"PeriodicalIF":1.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952420","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}
Fungal sensitization plays a crucial role in the development and severity of asthma. However, its prevalence and sensitization patterns vary significantly across different regions. This study aimed to determine the prevalence of fungal sensitization in asthmatic patients in this region and to identify the profile of the sensitizing fungi.
Method
This single-center cross-sectional study (February 2019–October 2022) at AIIMS Rishikesh investigated fungal sensitization in asthma patients. Skin prick tests (SPT) for nine fungal allergens (Aspergillus fumigatus, Alternaria alternata, Cladosporium herbarum, Fusarium moniliforme, Helminthosporium halodes, Penicillium chrysogenum, Rhyzopus nigricans, Serpula lacrymans, & Botrytis cinerea) and specific IgE by Immunoblot Assay (IBA) for eight fungi (Aspergillus spp, Alternaria alternata, Cladosporium herbarum, Penicillium chrysogenum, Rhyzopus nigricans, Mucor racemosus Candida albicans and Trichophyton mentagrophytes) were performed. Sputum samples were cultured on Sabouraud's Dextrose Agar, identified by MALDI-TOF. Statistical analysis, including ANOVA, Chi-square, and Kappa statistics, assessed correlations with age, sex, and concordance between SPT and IBA.
Results
Overall 51 % of individuals were sensitized for one or more fungal antigen based on SPT and/or specific serum IgE results. Monosensitization was observed in 13.3 % patients while 37.6 were sensitized to multiple fungal species. Females were significantly more sensitized (p-value = 0.019). A. fumigatus showed maximum sensitization (37.6 %) followed by P. chrysogenum (23.1 %), Rhyzopus (21.8 %), Candida (23.1 %), Trichophyton (21.2 %), Helminthosporum (18.8 %) and Alternaria(15.8 %). Concordance between the two tests ranged from 48.1 % to 72.1 % for individual fungi, maximum being in A. fumigatus and minimum in C. herbarum. Kappa-agreement was moderate for A. fumigatus and A. alternata but was found to be statistically significant for all the five fungi.
Conclusion
This study highlights the high prevalence and diverse spectrum of fungal sensitization among asthma patients in northern India, emphasizing the need for region-specific diagnostic approaches and routine testing to improve early detection and tailored management strategies.
{"title":"Prevalence and spectrum of fungal sensitization in bronchial asthma: Insights from Northern India","authors":"Sangeeta Deka , Girish Sindhwani , Deepjyoti Kalita , Pratima Gupta , Hiranya Saikia","doi":"10.1016/j.ijmmb.2025.100945","DOIUrl":"10.1016/j.ijmmb.2025.100945","url":null,"abstract":"<div><h3>Purpose</h3><div>Fungal sensitization plays a crucial role in the development and severity of asthma. However, its prevalence and sensitization patterns vary significantly across different regions. This study aimed to determine the prevalence of fungal sensitization in asthmatic patients in this region and to identify the profile of the sensitizing fungi.</div></div><div><h3>Method</h3><div>This single-center cross-sectional study (February 2019–October 2022) at AIIMS Rishikesh investigated fungal sensitization in asthma patients. Skin prick tests (SPT) for nine fungal allergens (<em>Aspergillus fumigatus</em>, <em>Alternaria alternata</em>, <em>Cladosporium herbarum</em>, <em>Fusarium moniliforme</em>, <em>Helminthosporium halodes, Penicillium chrysogenum</em>, <em>Rhyzopus nigricans</em>, <em>Serpula lacrymans,</em> & <em>Botrytis cinerea</em>) and specific IgE by Immunoblot Assay (IBA) for eight fungi (Aspergillus spp, <em>Alternaria alternata</em>, <em>Cladosporium herbarum</em>, <em>Penicillium chrysogenum</em>, <em>Rhyzopus nigricans</em>, <em>Mucor racemosus Candida albicans</em> and <em>Trichophyton mentagrophytes</em>) were performed. Sputum samples were cultured on Sabouraud's Dextrose Agar, identified by MALDI-TOF. Statistical analysis, including ANOVA, Chi-square, and Kappa statistics, assessed correlations with age, sex, and concordance between SPT and IBA.</div></div><div><h3>Results</h3><div>Overall 51 % of individuals were sensitized for one or more fungal antigen based on SPT and/or specific serum IgE results. Monosensitization was observed in 13.3 % patients while 37.6 were sensitized to multiple fungal species. Females were significantly more sensitized (<em>p-value</em> = 0.019). <em>A. fumigatus</em> showed maximum sensitization (37.6 %) followed by <em>P. chrysogenum</em> (23.1 %), <em>Rhyzopus</em> (21.8 %), <em>Candida</em> (23.1 %), <em>Trichophyton</em> (21.2 %), <em>Helminthosporum</em> (18.8 %) and <em>Alternaria</em>(15.8 %)<em>.</em> Concordance between the two tests ranged from 48.1 % to 72.1 % for individual fungi, maximum being in <em>A. fumigatus</em> and minimum in <em>C. herbarum.</em> Kappa-agreement was moderate for <em>A. fumigatus and A. alternata</em> but was found to be statistically significant for all the five fungi.</div></div><div><h3>Conclusion</h3><div>This study highlights the high prevalence and diverse spectrum of fungal sensitization among asthma patients in northern India, emphasizing the need for region-specific diagnostic approaches and routine testing to improve early detection and tailored management strategies.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"58 ","pages":"Article 100945"},"PeriodicalIF":1.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925882","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 : 2025-08-22DOI: 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":"2025-08-22","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}
Pub 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":"2025-08-14","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 : 2025-08-13DOI: 10.1016/j.ijmmb.2025.100951
Shreya Singh , Sumeeta Khurana , Pranita Pradhan
Background
Alveolar echinococcosis (AE) is a life-threatening parasitic disease caused by Echinococcus multilocularis, often misdiagnosed as malignancy. Though historically considered non-endemic in India, recent reports suggest an emerging trend, particularly in Kashmir. The lack of systematic data on Indian AE cases has limited our understanding of its epidemiology warranting a systematic description of Indian AE cases.
Methods
We performed an individual participant data meta-analysis (IPD-MA) of published AE cases in India. A comprehensive literature search across PubMed, Embase, Web of Science, Scopus and ProQuest, identified 19 studies reporting AE cases in India. Of these, 17 provided individual patient data for meta-analysis, comprising 39 cases. Data on demographics, clinical presentation, radiology, histopathology, serology, treatment, and outcomes were analyzed. Additionally, aggregate data from two studies without IPD-MA were incorporated to estimate the total national caseload.
Results
The median age of patients was 36 years, with a slight female predominance (48.7 %). Kashmir accounted for most cases (64.1 %). The liver was the most affected organ (79.5 %), followed by rare spinal and cerebral involvement. Abdominal pain was the predominant symptom (56.4 %). WHO-IWGE radiological staging classified most cases as advanced AE (stages IIIa/IIIb). Histopathological confirmation was available in 56.4 % of cases, and serological evidence was positive in 59 %. Anti-helminthic therapy (74.3 %) showed better outcomes (p = 0.002), though combination therapy with albendazole and praziquantel did not confer added benefit (p = 0.547). Surgical intervention was performed in 74.2 % but was not significantly associated with improved prognosis (p = 0.952). Mortality was 7.2 %, with a median follow-up of 12.5 months. Aggregate data revealed a total of 110 AE cases reported from India.
Conclusions
AE is increasingly reported from India, particularly in Kashmir, suggesting a possible local transmission cycle. Given the limited data on reservoir hosts, further ecological and veterinary studies are warranted. A national registry and One Health approach are essential for surveillance and control.
{"title":"Epidemiology and clinical characteristics of alveolar echinococcosis in India: A systematic review and individual participant data meta-analysis","authors":"Shreya Singh , Sumeeta Khurana , Pranita Pradhan","doi":"10.1016/j.ijmmb.2025.100951","DOIUrl":"10.1016/j.ijmmb.2025.100951","url":null,"abstract":"<div><h3>Background</h3><div>Alveolar echinococcosis (AE) is a life-threatening parasitic disease caused by <em>Echinococcus multilocularis</em>, often misdiagnosed as malignancy. Though historically considered non-endemic in India, recent reports suggest an emerging trend, particularly in Kashmir. The lack of systematic data on Indian AE cases has limited our understanding of its epidemiology warranting a systematic description of Indian AE cases.</div></div><div><h3>Methods</h3><div>We performed an individual participant data meta-analysis (IPD-MA) of published AE cases in India. A comprehensive literature search across PubMed, Embase, Web of Science, Scopus and ProQuest, identified 19 studies reporting AE cases in India. Of these, 17 provided individual patient data for meta-analysis, comprising 39 cases. Data on demographics, clinical presentation, radiology, histopathology, serology, treatment, and outcomes were analyzed. Additionally, aggregate data from two studies without IPD-MA were incorporated to estimate the total national caseload.</div></div><div><h3>Results</h3><div>The median age of patients was 36 years, with a slight female predominance (48.7 %). Kashmir accounted for most cases (64.1 %). The liver was the most affected organ (79.5 %), followed by rare spinal and cerebral involvement. Abdominal pain was the predominant symptom (56.4 %). WHO-IWGE radiological staging classified most cases as advanced AE (stages IIIa/IIIb). Histopathological confirmation was available in 56.4 % of cases, and serological evidence was positive in 59 %. Anti-helminthic therapy (74.3 %) showed better outcomes (p = 0.002), though combination therapy with albendazole and praziquantel did not confer added benefit (p = 0.547). Surgical intervention was performed in 74.2 % but was not significantly associated with improved prognosis (p = 0.952). Mortality was 7.2 %, with a median follow-up of 12.5 months. Aggregate data revealed a total of 110 AE cases reported from India.</div></div><div><h3>Conclusions</h3><div>AE is increasingly reported from India, particularly in Kashmir, suggesting a possible local transmission cycle. Given the limited data on reservoir hosts, further ecological and veterinary studies are warranted. A national registry and One Health approach are essential for surveillance and control.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"57 ","pages":"Article 100951"},"PeriodicalIF":1.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852585","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}
Scrub typhus has emerged as a prominent etiological agent of acute encephalitis syndrome (AES) in India. However, there is a dearth of information on its involvement in AES in South India. Knowing the specific etiology and its prevalence would help in the definitive management of patients, perhaps improving morbidity and mortality.
Methods
A cross-sectional descriptive study was performed in Pondicherry to determine the proportion of adult patients with Orientia tsutsugamushi infection causing AES between January 2020 and December 2021. Diagnosis was performed by a combination of a positive scrub IgM ELISA or a positive real-time PCR in CSF and/or blood sample. Phylogenetic analysis of O. tsutsugamushi isolates was performed to study variations in the 56-kDa type specific antigen (TSA) of O. tsutsugamushi. Seroprevalence of Orientia tsutsugamushi IgG antibodies was assessed using ELISA targeting 56KDa protein.
Results
Eleven percent of AES in adults was attributable to scrub typhus. The majority of sequences from the 19 isolates sequenced, according to phylogenetic analysis of 56-kDa proteins, resembled Karp- or Gilliam-like strains (63.1 % and 26.3 %, respectively). In Puducherry, O. tsutsugamushi IgG seropositivity was found to be 35 %.
Conclusion
This study emphasized the importance of scrub typhus as the common etiology of AES in Puducherry, underscoring the need to integrate routine scrub typhus testing into AES diagnostic algorithm. Sequencing-based analysis of representative samples across the country helps to understand the diversity of O. tsutsugamushi.
{"title":"\"Acute encephalitis syndrome in adults: Molecular and serological evidence of Orientia tsutsugamushi infection in Puducherry and neighboring districts of Tamil Nadu\"","authors":"Symphonia Anguraj, Barathidasan Rajamani, Anitha Gunalan, Vivekanandan Pillai, Rahul Dhodapkar","doi":"10.1016/j.ijmmb.2025.100953","DOIUrl":"10.1016/j.ijmmb.2025.100953","url":null,"abstract":"<div><h3>Background</h3><div>Scrub typhus has emerged as a prominent etiological agent of acute encephalitis syndrome (AES) in India. However, there is a dearth of information on its involvement in AES in South India. Knowing the specific etiology and its prevalence would help in the definitive management of patients, perhaps improving morbidity and mortality.</div></div><div><h3>Methods</h3><div>A cross-sectional descriptive study was performed in Pondicherry to determine the proportion of adult patients with <em>Orientia tsutsugamushi</em> infection causing AES between January 2020 and December 2021. Diagnosis was performed by a combination of a positive scrub IgM ELISA or a positive real-time PCR in CSF and/or blood sample. Phylogenetic analysis of <em>O. tsutsugamushi</em> isolates was performed to study variations in the 56-kDa type specific antigen (TSA) of <em>O. tsutsugamushi.</em> Seroprevalence of <em>Orientia tsutsugamushi</em> IgG antibodies was assessed using ELISA targeting 56KDa protein.</div></div><div><h3>Results</h3><div>Eleven percent of AES in adults was attributable to scrub typhus. The majority of sequences from the 19 isolates sequenced, according to phylogenetic analysis of 56-kDa proteins, resembled Karp- or Gilliam-like strains (63.1 % and 26.3 %, respectively). In Puducherry, <em>O. tsutsugamushi</em> IgG seropositivity was found to be 35 %.</div></div><div><h3>Conclusion</h3><div>This study emphasized the importance of scrub typhus as the common etiology of AES in Puducherry, underscoring the need to integrate routine scrub typhus testing into AES diagnostic algorithm. Sequencing-based analysis of representative samples across the country helps to understand the diversity of <em>O. tsutsugamushi</em>.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"57 ","pages":"Article 100953"},"PeriodicalIF":1.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855089","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}
Parathyridaria percutanea is an unusual fungus causing subcutaneous phaeohyphomycosis in India. A 74-year-old female presented with multiple swellings on the dorsum of her left hand for 6 months. The patient does not have Diabetes mellitus, is not immunocompromised, and does not have any other co-morbidities. Histopathological stains showed fungal hyphae in the epidermis and dermis. On the KOH mount, phaeoid fungal hyphae were observed. On culture, cream to grey fungal growth was observed, which was non-sporulating. This was identified as Parathyridaria percutanea by sequencing. Molecular techniques are an important diagnostic tool for the accurate identification of these unusual fungal isolates.
{"title":"Subcutaneous phaeohyphomycosis due to a rare fungus Parathyridaria percutanea: First reported case from central India","authors":"Archana Keche , Girish Patil , Satyaki Ganguly , Rakesh Gupta , Shivaprakash M. Rudramurthy","doi":"10.1016/j.ijmmb.2025.100954","DOIUrl":"10.1016/j.ijmmb.2025.100954","url":null,"abstract":"<div><div><em>Parathyridaria percutanea</em> is an unusual fungus causing subcutaneous phaeohyphomycosis in India. A 74-year-old female presented with multiple swellings on the dorsum of her left hand for 6 months. The patient does not have Diabetes mellitus, is not immunocompromised, and does not have any other co-morbidities. Histopathological stains showed fungal hyphae in the epidermis and dermis. On the KOH mount, phaeoid fungal hyphae were observed. On culture, cream to grey fungal growth was observed, which was non-sporulating. This was identified as <em>Parathyridaria percutanea</em> by sequencing. Molecular techniques are an important diagnostic tool for the accurate identification of these unusual fungal isolates.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"57 ","pages":"Article 100954"},"PeriodicalIF":1.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830200","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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