Indian Journal of Medical Microbiology最新文献

{"title":"Risk factors and clinical outcomes in patients with colistin-resistant Klebsiella pneumoniae bloodstream infection: A retrospective analysis","authors":"Rimjhim Kanaujia ,&nbsp;Imola Jamir ,&nbsp;Navneet Arora ,&nbsp;Manisha Biswal ,&nbsp;Navneet Sharma ,&nbsp;Pallab Ray ,&nbsp;Ashok Kumar Pannu ,&nbsp;Archana Angrup","doi":"10.1016/j.ijmmb.2025.100882","DOIUrl":"10.1016/j.ijmmb.2025.100882","url":null,"abstract":"<div><h3>Purpose</h3><div>Increase in the incidence of colistin-resistant <em>K. pneumoniae</em> (ColR) necessitates the study of risk factors responsible for its emergence. The current study aims to investigate the risk factors and clinical outcomes in ColR patients.</div></div><div><h3>Material and methods</h3><div>A retrospective study was conducted at a tertiary care hospital in India over 18 months (March 2021 to August 2022). We included patients &gt;18 years (41 male, 38 female), with ColR and colistin-intermediate (ColI) strains. These patients were assessed for demographics, underlying diseases, antimicrobial treatment, clinical scores (APACHE II, SOFA), and outcome.</div></div><div><h3>Results</h3><div>The presence of a central venous catheter (CVC) was a significantly associated risk factor for ColR infections (p = 0.011). Additionally, prior antibiotic exposure within 3 months (p = 0.049) and CVC presence (p = 0.034) were associated with non-survival among ColR patients. Higher APACHE II and SOFA scores were associated with mortality among ColI patients. The presence of CCI &gt;3 (p = 0.040) and previous history of ICU stay (p = 0.032) emerged as significant factors associated with the isolation of ColR <em>K. pneumoniae</em> among patients with previous history of colistin/polymyxin intake.</div></div><div><h3>Conclusion</h3><div>The study highlights the risk factors associated with ColR <em>K. pneumoniae.</em> These findings underscore the need for prudent antimicrobial stewardship.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"56 ","pages":"Article 100882"},"PeriodicalIF":1.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139407","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}

{"title":"Phenotypic and genotypic characterization of MRSA isolated from health care workers in tertiary care hospital","authors":"Kavita Sisodia ,&nbsp;Anupam Kr Anveshi ,&nbsp;Dabet Ranga ,&nbsp;Dharmender Kumar ,&nbsp;Rajni Gaind","doi":"10.1016/j.ijmmb.2025.100871","DOIUrl":"10.1016/j.ijmmb.2025.100871","url":null,"abstract":"<div><h3>Background</h3><div>Methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) is a significant public health concern, particularly in healthcare settings where healthcare workers (HCWs) act as reservoirs. The aim of this study was to evaluate various phenotypic methods for detection of MRSA among HCWs and study molecular epidemiology of the MRSA isolates by SCC<em>mec</em> typing.</div></div><div><h3>Methods</h3><div>A total of 368 nasal swabs were collected from HCWs to study MRSA carriage. Samples were cultured on 5 % sheep blood agar and CHROMagar™ MRSA. Antimicrobial susceptibility was performed using disc diffusion and MIC was determined for select antibiotics as per CLSI guidelines. PCR was performed for detection of <em>mecA</em>, <em>mecC</em> and SCC<em>mec</em> typing. Performance of phenotypic test: oxacillin, cefoxitin (MIC μg/ml) and cefoxitin disc diffusion (DD) was evaluated for detection of MRSA.</div></div><div><h3>Results</h3><div>Colonization with <em>S. aureus</em> and MRSA (<em>mecA</em> positive) was detected among 65 (17.7 %) and 27 (7.3 %) HCWs respectively. CHROMagar™ MRSA correctly identified 24/27 isolates positive for <em>mecA</em> gene. Among MRSA isolates MDR was high. High level resistance to mupirocin was not detected. Cefoxitin DD was a reliable phenotypic test for MRSA detection showing 100 % sensitivity and specificity. Very major errors (25.9 %) were observed with oxacillin MIC. SCC<em>mec</em> typeV (66.6 %) was the most prevalent, followed by SCC<em>mec</em> IV. SCC<em>mec</em> type I-III, associated with hospital-acquired MRSA (HA-MRSA) were not detected.</div></div><div><h3>Conclusion</h3><div>The significant MRSA carriage rate (7.3 %) among HCWs underscores the need for screening HCWs. CHROMagar^TM MRSA can be used for rapid screening of HCWs and patients for implementing early decolonization and infection control practices. Results from phenotypic test indicate that cefoxitin disc is a reliable method for detection of MRSA. The high prevalence of SCC<em>mec</em> type V in hospital settings is a concern as CA-MRSA strains tend to be more virulent and easily transmissible compared to traditional HA-MRSA.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"56 ","pages":"Article 100871"},"PeriodicalIF":1.4,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101682","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}

{"title":"Beyond the usual suspects: A case report of multi-etiological and multidrug-resistant Candida onychomycosis","authors":"Hasti Nouraei ,&nbsp;Mehdi Ghahartars ,&nbsp;Zahra Zareshahrabadi ,&nbsp;Keyvan Pakshir","doi":"10.1016/j.ijmmb.2025.100870","DOIUrl":"10.1016/j.ijmmb.2025.100870","url":null,"abstract":"<div><div>This is a rare case of <em>Candida</em> onychomycosis caused by three <em>Candida</em> species that were resistant to several antifungal drugs. A 56-year-old Iranian woman with no previous medical or injury history experienced discoloration and lifting of her left thumbnail for six months. Laboratory tests identified yeast and pseudohyphae consistent with <em>Candida</em> onychomycosis. Conventional and molecular techniques confirmed that onychomycosis was caused by three different <em>Candida</em> species. All strains were resistant to various antifungal drugs. Therapeutic failure, in addition to multi-drug resistance, may be due to the presence of multiple etiological agents.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"56 ","pages":"Article 100870"},"PeriodicalIF":1.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093479","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}

{"title":"Schistosoma haematobium infection in a traveller returning from an endemic country","authors":"Sapna Joy ,&nbsp;Athulya Sadeesh P ,&nbsp;Sandeep Prabhakaran ,&nbsp;Devi K. Bhanu ,&nbsp;Anil Kumar","doi":"10.1016/j.ijmmb.2025.100867","DOIUrl":"10.1016/j.ijmmb.2025.100867","url":null,"abstract":"<div><div>Despite being considered non-endemic for human schistosomiasis, previous studies from India have described at least three endemic foci, with occasional case reports of autochthonous cases and cercarial dermatitis. We report a case of chronic haematuria in a 31-year-old male returning from Malawi due to <em>Schistosoma haematobium.</em></div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100867"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903793","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}

{"title":"Invasive Corynebacterium striatum infection: A case of concurrent isolation from blood and cerebrospinal fluid","authors":"S.A. Rahil Pasha,&nbsp;T. Vidhya,&nbsp;S. Nagarathna,&nbsp;Arghadip Samaddar,&nbsp;H.B. Veena Kumari","doi":"10.1016/j.ijmmb.2025.100869","DOIUrl":"10.1016/j.ijmmb.2025.100869","url":null,"abstract":"<div><div>A 60-year-old male patient presented with headache and vomiting following a fall. Computed Tomography (CT) brain imaging showed a subarachnoid hemorrhage due to aneurysm rupture in the anterior communicating artery (ACOM) and direct anterior cerebral artery (DACA). Right frontotemporal craniotomy and clipping of both ACOM and DACA aneurysms were performed. <em>Corynebacterium striatum</em> was circumstantially isolated from both blood and cerebrospinal fluid (CSF) during the hospital stay. This report summaries the patient's clinical course, management of condition, and the consequences of this rare infection.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100869"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947537","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}

{"title":"First Human Parechovirus CNS infections from India: a report of two cases","authors":"Kakhangchung Panmei ,&nbsp;Deepayan Biswas ,&nbsp;Shoba Mammen ,&nbsp;Rajesh Kannangai ,&nbsp;Amith Balachandran ,&nbsp;Valsan Philip Verghese ,&nbsp;Anitha Jasper ,&nbsp;Asha Mary Abraham","doi":"10.1016/j.ijmmb.2025.100853","DOIUrl":"10.1016/j.ijmmb.2025.100853","url":null,"abstract":"<div><div>The manifestations of HPeV infection vary from asymptomatic to serious conditions like meningitis, encephalitis, and neonatal sepsis.[1,2] While the infection is common among children, especially newborns, recent studies have demonstrated that HPeV can lead to severe cases of meningitis and encephalitis in adults.[3] We present the first cases of acute HPeV CNS infections from India, meningitis in an adult and meningoencephalitis in a paediatric patient.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100853"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891839","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}

{"title":"Paragonimiasis: A continuing public health problem in northeast India","authors":"Takhellambam Shantikumar Singh ,&nbsp;Khuraijam Ranjana Devi ,&nbsp;Khumanthem Ratankumar ,&nbsp;Shakti Laishram ,&nbsp;Thangjam Dhabali ,&nbsp;Sunanda Haorongbam","doi":"10.1016/j.ijmmb.2025.100866","DOIUrl":"10.1016/j.ijmmb.2025.100866","url":null,"abstract":"<div><h3>Purpose</h3><div>Trematode species belonging to the genus <em>Paragonimus</em> are the source of the food-borne parasitic zoonosis known as paragonimiasis. The disease has been identified as an outbreak in northeastern India since the early 1980s and is frequently diagnosed as tuberculosis because of similar clinical and radiological findings. This study is an attempt to update the clinic-radiological features and geographical distribution of the disease in recent times.</div></div><div><h3>Methods</h3><div>We retrospectively collected and analysed the data of 37 paragonimiasis suspected cases attending three healthcare facilities in Manipur from 2011 to 2023. Clinical data, history of food habits and geographical location, and laboratory data were retrieved and analysed. In the microbiology laboratory, sputum and pleural fluid examination were subjected to microbiological examination and serological testing using DIGFA, an immunochromatographic dot blot rapid test.</div></div><div><h3>Results</h3><div>Out of 37 cases, 32 cases were confirmed to be paragonimiasis. Clinical manifestations were pleural effusion (n = 11), cerebral with pulmonary (n = 1), cutaneous (n = 1), and pulmonary (n = 19). All patients had a history of consuming crabs. Thirteen cases were pediatric patients, representing 40.6 %. At the time of presentation, 22 cases (68.75 %) were clinically suspected to be TB, and 16 (50 %) of them were already receiving anti-TB drugs. The patients were treated with oral praziquantel, 25 mg/kg of body weight, three times a day.</div></div><div><h3>Conclusions</h3><div>The disease remains a public health concern in Manipur, as evidenced by the identification of new endemic foci. It continues to be misdiagnosed and mismanaged as tuberculosis. More awareness and a policy to examine AFB smear-negative sputum samples for paragonimiasis in patients with high eosinophil count is the need of the hour.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100866"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927587","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}

{"title":"A study on the effectiveness of an antifungal stewardship program in immunocompromised patients in a tertiary-care teaching hospital: The antifungal stewardship (TAFS) study","authors":"Amita Jacob ,&nbsp;Jisha Sara John ,&nbsp;Hanna Alexander ,&nbsp;Biju George ,&nbsp;Sushil Selvarajan ,&nbsp;Prasanna Samuel ,&nbsp;R. Nagayazhini ,&nbsp;Rajiv Karthik ,&nbsp;Priscilla Rupali","doi":"10.1016/j.ijmmb.2025.100865","DOIUrl":"10.1016/j.ijmmb.2025.100865","url":null,"abstract":"<div><h3>Introduction</h3><div>Anti-fungal stewardship (AFS) is a neglected aspect of antimicrobial stewardship programs. This study aimed to examine the effectiveness of an AFS program to ensure rational prescribing of antifungals via a post-prescription review and feedback method.</div></div><div><h3>Methods</h3><div>In this prospective, interrupted time series analysis, AFS was done on adult patients admitted to the department of hematology in a tertiary care hospital in South India. In the pre-intervention phase, patients on anti-fungal therapy for more than 48 h were identified and baseline data was collected. In the intervention phase, patients on antifungals for &gt;48 h were assessed by an AFS team including an infectious diseases specialist and appropriate recommendations were made regarding modification or discontinuation of the antifungals where required. Acceptance of the intervention by the treating team and clinical outcomes were recorded.</div></div><div><h3>Results</h3><div>A total of 193 courses of antifungal therapy in 152 patients were analyzed over 6 months, of which 107 courses belonged to the pre-intervention phase and 86 were in the intervention phase. In the intervention phase, the AFS teams recommended that 15 (17.44 %) of antifungal prescriptions be modified. Among these, 66 % of the recommendations were accepted by the treating physician. Days of therapy per 1000 patient days were calculated for each individual anti-fungal drug and there was a significant reduction in consumption of antifungals, particularly voriconazole, posaconazole and echinocandins in the intervention phase. There was no statistically significant difference in the in-hospital mortality [26.16 % vs 23. 25 % (p = 0.64)] between the two groups.</div></div><div><h3>Conclusion</h3><div>In this study, a focused post prescription review and feedback in an antifungal stewardship program appeared to significantly decrease the prescription of antifungal medication without adversely affecting patient outcomes.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100865"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899279","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}

{"title":"Alert and Aware: Rising cases of community-acquired group B Streptococcus meningitis in immunocompetent adults","authors":"T. Vidhya,&nbsp;K. Akshay,&nbsp;H.B. Veenakumari,&nbsp;S. Nagarathna,&nbsp;Argadhip Samaddhar","doi":"10.1016/j.ijmmb.2025.100868","DOIUrl":"10.1016/j.ijmmb.2025.100868","url":null,"abstract":"<div><div>Once traditionally considered a neonatal pathogen, Group B Streptococcus (GBS) is a pathogen of growing importance in adults and those with underlying comorbidities. This case series discusses five cases of community-acquired GBS meningitis in adults who presented with history of fever, altered mental status, and other neurological symptoms. Gram stain revealed pus cells and gram-positive cocci and culture was positive in four out of five cases and one isolate was CAMP-negative.In culture negative case PCR clinched the diagnosis. This case series highlights the importance of considering GBS as a cause of community-acquired meningitis in immunocompetent adults.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100868"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931837","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}

{"title":"Diagnostic and surveillance algorithm for acute encephalitis syndrome: A systematic approach to etiological identification","authors":"Mala Chhabra ,&nbsp;Mahima Mittal ,&nbsp;Winsley Rose ,&nbsp;Harmanmeet Kaur ,&nbsp;Anoop Velayudhan ,&nbsp;Nivedita Gupta ,&nbsp;Saumya Deol ,&nbsp;Vikas Manchanda ,&nbsp;Megha Brijwal ,&nbsp;Ruchita Chhabra ,&nbsp;Rahul Dhodapkar ,&nbsp;Charu Jain ,&nbsp;V. Ravi ,&nbsp;Ravindra Kumar Garg ,&nbsp;Nandini Duggal ,&nbsp;Valsan Philip Verghese ,&nbsp;Rakesh Lodha","doi":"10.1016/j.ijmmb.2025.100858","DOIUrl":"10.1016/j.ijmmb.2025.100858","url":null,"abstract":"<div><h3>Background</h3><div>Acute Encephalitis Syndrome (AES) is a major public health concern, causing sporadic cases and outbreaks with high morbidity and mortality. Its diverse aetiology includes many zoonotic pathogens, and its diagnosis and management in India are complicated by geographical, seasonal, and cultural diversity, along with limited diagnostic resources. As part of the ICMRs “One Health\" initiative, this paper addresses the need for a structured diagnostic and surveillance algorithm to enhance etiological identification and improve AES management and public health response.</div></div><div><h3>Objective</h3><div>To develop a systematic diagnostic and surveillance algorithm for AES diagnosis, prioritizing investigations based on clinical, epidemiological, and laboratory findings to optimize patient outcomes and strengthen public health interventions.</div></div><div><h3>Result</h3><div>The proposed approach prioritizes AES etiological diagnosis based on geographical and seasonal pathogen prevalence, alignment with national programs, treatment availability, diagnostic feasibility, clinical and radiological suspicion, and public health surveillance needs. AES cases should be managed at secondary or tertiary care facilities, where appropriate tests can be conducted based on resource feasibility. A subset of positive and negative samples should undergo genomic characterization to identify novel pathogens.</div></div><div><h3>Conclusion</h3><div>This framework will enhance pathogen identification, improve patient management, and support public health efforts, reinforcing ICMR's commitment to combating <span>AES</span> through the “One Health\" approach.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"55 ","pages":"Article 100858"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922501","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}