Indian Journal of Medical Microbiology最新文献

{"title":"Exploring the necessity of molecular detection for Streptococcus dysgalactiae subsp equisimilis: often misdiagnosed, and emerging pathogen.","authors":"Rosemol Varghese, V Aravind, K Kirubanandan, Purva Mathur, V Balaji","doi":"10.1016/j.ijmmb.2024.100744","DOIUrl":"https://doi.org/10.1016/j.ijmmb.2024.100744","url":null,"abstract":"<p><strong>Background: </strong>Streptococcus dysgalactiae subsp equisimilis (SDSE) is an emerging pathogen causing pharyngitis and post-streptococcal sequelae like S. pyogenes. SDSE was initially considered a commensal microorganism inhabiting the upper respiratory tract and skin. However, recently it has gained attention due to an increase in invasive SDSE infections, which were reported in the early 20th century.</p><p><strong>Objectives: </strong>This review is to bring awareness of SDSE in the medical microbiologists that often leads to the under reporting or misdiagnosis of SDSE. This also highlights the clinical spectrum of infections and the molecular epidemiology of SDSE.</p><p><strong>Content: </strong>Diagnosis of SDSE in clinical laboratories is challenging, because SDSE can be seen expressing either of the three Lancefield antigen Groups, Group A, C, and G. While MALDI-TOF (Matrix-Assisted Laser Desorption/Ionization Time-of-Flight) is a discriminatory method for identifying SDSE, its high cost can limit its use in many laboratories. Currently, there is limited data on SDSE, and further studies are required to associate the disease outcome and the emm type/ ST of SDSE in India and other developing countries. This review highlights the importance of recognizing SDSE as an emerging pathogen, and to screen for SDSE in infections similar to S.pyogenes, especially in regions such as India with a high incidence of Streptococcal diseases.</p>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464210","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":"Characterization of clinical infection and drug resistance of group B streptococcus in Chengdu, China","authors":"Qin Wang ,&nbsp;Yuxia Huang ,&nbsp;Xiaoli Liu ,&nbsp;Lin Deng ,&nbsp;Jingruo Xia ,&nbsp;Feng Wen ,&nbsp;Chenggui Liu ,&nbsp;Xuan Zhu ,&nbsp;Jiajia Zhang","doi":"10.1016/j.ijmmb.2024.100742","DOIUrl":"10.1016/j.ijmmb.2024.100742","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical infection characteristics and antibiotic resistance of Group B Streptococcus (<em>Streptococcus agalactiae</em>, GBS) in Chengdu, China, from 2019 to 2021, as well as to provide data to support rational clinical drug use.</div></div><div><h3>Methods</h3><div>This was a retrospective study to collect 203 culture-positive GBS strains isolated from January 2019 to December 2021 in Chengdu, China, all of which were identified by the VITEK 2 Compact automated microbial Bacterial identification instrument. Data were derived using WHONET 5.6 software. The sample type and ward distribution were counted. Pregnant women and newborns were screened from the original data and their pregnancy outcomes were calculated respectively.</div></div><div><h3>Results</h3><div>GBS strains were mainly concentrated in obstetrics and neonatology departments, accounting for 40.9 % and 33.5 %. The types of specimens were mainly vaginal secretions, amniotic fluid and sputum, accounting for 25.6 %, 26.1 % and 18.7 %, respectively. Chorioamnionitis, premature rupture of membranes and preterm delivery occurred mainly in pregnant women after infection, accounting for 44.4 %, 31.5 % and 24.1 %. Neonates, on the other hand, were mainly diagnosed with neonatal pneumonia, neonatal sepsis, respiratory failure and septic meningitis, accounting for 91.8 %, 61.2 %, 44.9 % and 16.3 % of all positive neonates. 840 pregnant women were screened for GBS colonization from 2019 to 2021, and a total of 108 GBS positive pregnant women were identified, with a GBS colonization rate of 12.9 %. A total of 9 neonates from 108 GBS positive pregnant women developed early-onset disease. The morbidity in neonates was 8.3 %. No strains resistant to penicillin and ampicillin were found, while the resistance rates of tetracycline and clindamycin were higher than 50 %, respectively 60.1 % and 53.2 %.</div></div><div><h3>Conclusion</h3><div>GBS infection mainly affected pregnant women and newborns in Chengdu, China, which can lead to adverse maternal and infant outcomes. Attention should be paid to strengthening general screening of GBS in perinatal urogenital secretions and the prevention strategy of IAP (intrapartum antibiotic prophylaxis). Antimicrobial therapy should be administered with appropriate antibiotics. Penicillin was still the first line drug for the treatment of GBS. These initiatives were important to reduce mother-to-child transmission and neonatal infections.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390151","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":"Klebsiella pneumoniae infections and phage therapy","authors":"Alakh Narayan Singh,&nbsp;Aprajita Singh,&nbsp;Sudhir Kumar Singh,&nbsp;Gopal Nath","doi":"10.1016/j.ijmmb.2024.100736","DOIUrl":"10.1016/j.ijmmb.2024.100736","url":null,"abstract":"<div><h3>Objective</h3><div>Carbapenem-colistin-resistant <em>Klebsiella pneumoniae</em> has emerged as a serious global problem. <em>Klebsiella pneumoniae</em> is a major culprit in healthcare settings and is responsible for septicemia, urinary tract infections, pneumonia, meningitis, burn wound and surgical site infections, and liver abscesses even in younger and healthier population worldwide. The formation of biofilm prevents antibiotics from reaching the bacteria and exerting their effector mechanism. The non-availability of therapeutic alternatives (antibiotic therapy) further complicates the scenario. However, in the era of antibiotic resistance, bacteriophage therapy emerges as a ray of hope against antibiotic-resistant bacteria.</div></div><div><h3>Method</h3><div>The present review focuses on the therapeutic potential of bacteriophages as an antimicrobial agent with special reference to safety, specificity, efficacy, dosage, and dosage frequency against Pan-Drug Resistant (PDR) <em>K. pneumoniae,</em> both <em>in-vitro</em> and <em>in-vivo</em> (animals and human) studies.</div></div><div><h3>Result</h3><div>This review highlights the perspectives therapeutic potential of bacteriophages, their impact on the host immune system, combination therapy, and bacteriophage-encoded gene product endolysin, artificial lysins (Artilysins), polysaccharide depolymerase, and peptidoglycan hydrolases.</div></div><div><h3>Conclusion</h3><div>This review briefly describes the application of bacteriophage and its encoded gene products in clinical trials.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365109","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":"Vulvovaginal candidiasis in pregnant women attending a tertiary care centre in North-Eastern India","authors":"Mahuya Roy ,&nbsp;Tapan Majumdar ,&nbsp;Jayanta Ray","doi":"10.1016/j.ijmmb.2024.100738","DOIUrl":"10.1016/j.ijmmb.2024.100738","url":null,"abstract":"<div><h3>Background</h3><div><em>Candida</em> colonisation in vagina was found to be 20 %, rising to 30 % during pregnancy. According to studies, the prevalence of VVC during pregnancy is higher than healthy women. During pregnancy, candidal colonisation increases, both symptomatic and asymptomatic. However, the difference between strains causing symptomatic infection and those that cause asymptomatic infection is unknown.</div></div><div><h3>Objective</h3><div>This study aimed to compare the virulence factors of Candida VVC isolates from symptomatic and asymptomatic pregnant women.</div></div><div><h3>Methods</h3><div>The study included 120 pregnant women- 60 symptomatic and 60 asymptomatic, who presented to the Obstetrics and Gynaecology Outpatient Department with vaginitis symptoms. High vaginal swabs from the patient and used for gram stain, direct wet mount, pH detection and fungal culture in SDA with and without antibiotics. Germ tube tests, growth in CMA, and HiCrome <em>Candida</em> Differential Agar were used to identify yeast colonies grown in culture. The isolates were then examined for virulence factors like biofilm formation, phospholipase, coagulase, and hemolysin. Antifungal susceptibility was determined using E-test.</div></div><div><h3>Results</h3><div>The current study reveals a high prevalence of Vulvovaginal Candidiasis in pregnant women(35 %). Asymptomatic patients had lower proportion of VVC than symptomatic patients. Non albicans <em>Candida</em>(NAC) outnumbered <em>Candida albicans</em>. Although <em>Candida albicans</em> growth was predominant in asymptomatic patients. Virulence studies revealed that Candida spp. isolated from symptomatic patients expressed a higher proportion of virulence factors. Besides NAC has higher proportion of expressing virulence factors than <em>Candida albicans</em> and has higher propensity to cause infection especially in symptomatic pregnant women. Antifungal susceptibility testing shows Itraconazole to be most sensitive for VVC treatment but <em>Candida albicans</em> was most susceptible to fluconazole while NAC had the least.</div></div><div><h3>Conclusions</h3><div>The study emphasizes the importance of routine screening of symptomatic pregnant women for VVC, as syndromic treatment will increase antifungal resistance, particularly in NAC.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345836","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":"Utilization of MALDI-TOF MS in the etiological diagnosis of deep-seated anaerobic bacterial infections","authors":"Ashish William,&nbsp;Srestha Mitra,&nbsp;Oves Siddiqui,&nbsp;Prabhav Aggarwal,&nbsp;Sonal Saxena","doi":"10.1016/j.ijmmb.2024.100739","DOIUrl":"10.1016/j.ijmmb.2024.100739","url":null,"abstract":"<div><h3>Purpose</h3><div>Deep-seated abscesses can be caused by a wide array of bacteria in various anatomical sites, the precise identification of which is crucial for implementing organism-specific treatments which can reduce morbidity and mortality. MALDI-TOF MS is a powerful proteomic method for the swift and accurate identification of anaerobic organisms. The aim of this study was to investigate deep-seated infections by MALDI-TOF MS (in comparison to VITEK<strong>®</strong>2 ANC ID card and phenotypic biochemical tests) and to determine the susceptibility pattern of identified microorganisms.</div></div><div><h3>Materials and methods</h3><div>A total of 104 samples from patients suspected of deep-seated infections were aseptically collected and subjected to microscopy, aerobic/anaerobic cultures and subsequent identification via MALDI-TOF MS followed by antimicrobial susceptibility testing. Anaerobic bacteria were also identified using the VITEK-2 system and phenotypic biochemical tests.</div></div><div><h3>Results</h3><div>Out of the 104 samples tested, 41.3 % (43/104) showed positive results, predominantly in pus specimens (88 %). Mixed infections were found in 21 % of the positive cases. Of the 52 organisms identified from positive specimens, 19.2 % (10/52) were obligate anaerobes, with <em>Bacteroides fragilis</em> group being the most prevalent, followed by both <em>Clostridium perfringens</em> and <em>Clostridium sporogenes</em> respectively. <em>Escherichia coli</em> was observed to be the most common facultative anaerobic isolate. All obligate anaerobes were successfully identified to the species level via MALDI-TOF MS. In contrast, the VITEK<strong>®</strong>2 ANC ID card identified only 40 % (4/10) anaerobic bacteria to the species level. All obligate anaerobic organisms showed 100 % susceptibility to metronidazole, vancomycin and ertapenem. 25 % of the <em>Bacteroides</em> spp. and 50 % of <em>Clostridium perfringens</em> isolates were found to be resistant to clindamycin.</div></div><div><h3>Conclusion</h3><div>MALDI-TOF MS proves as a beneficial diagnostic tool for bacterial identification, eliminating the labour-intensive and time consuming conventional microbiological methods. Its accuracy of bacterial detection further helps in combating antibiotic resistance and improving patient outcomes in deep-seated infections.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371714","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":"‘Effectiveness of various sulbactam-based combination antibiotic therapy in the management of ventilator-associated pneumonia caused by carbapenem-resistant Acinetobacter baumannii in a tertiary care Health centre’","authors":"Monika Chaudhary ,&nbsp;Deepak Kumar ,&nbsp;Durga Shankar Meena ,&nbsp;Naresh Kumar Midha ,&nbsp;Gopal Krishana Bohra ,&nbsp;Vibhor Tak ,&nbsp;Subhashree Samantaray ,&nbsp;Navneet Kaur ,&nbsp;T.R. Neetha ,&nbsp;Sadik Mohammed ,&nbsp;Ankur Sharma ,&nbsp;Nikhil Kothari ,&nbsp;Pradeep Kumar Bhatia ,&nbsp;M.K. Garg","doi":"10.1016/j.ijmmb.2024.100737","DOIUrl":"10.1016/j.ijmmb.2024.100737","url":null,"abstract":"<div><h3>Objective</h3><div>Carbapenem-resistant <em>Acinetobacter baumannii</em> (CRAB) is a common cause of ventilator-associated pneumonia (VAP). Some in vitro data favour various combination antibiotic therapy. However, there is a need for more in vivo studies for the management of VAP caused by CRAB. This retrospective study was done to evaluate the effectiveness of various combination antibiotic therapy including sulbactam on outcomes of VAP caused by CRAB.</div></div><div><h3>Methods</h3><div>Adult patients (age ≥18 years) diagnosed with VAP caused by CRAB were included. Patients with polymicrobial infections were excluded from the study. Patients with CRAB associated VAP who were given sulbactam based antibiotic combinations were observed for outcomes. The primary outcome was 28-day mortality after diagnosis of VAP caused by CRAB. Reduction in serum HsCRP (High sensitivity C-reactive protein) during treatment and requirement of inotropes were the secondary outcomes. Outcomes were compared between various sulbactam based antibiotic combination therapies.</div></div><div><h3>Results</h3><div>A total of 103 patients were included. A total of 44 (42.7 %) patients received sulbactam and minocycline or sulbactam and polymyxin B dual antibiotic combination, and 59 (57.3 %) patients received sulbactam, polymyxin B and minocycline triple antibiotic combination. The percentage difference in 28 days mortality was 27.51 % (95 % CI 8.03 %–44.06 %; p = 0.005) in dual vs triple sulbactam based antibiotic combination therapy. The percentage difference in requirement of inotropes during therapy and HsCRP reduction after 7 days of therapy was 23.65 % (95 % CI 6.43 %–38.3 %; p = 0.007) and 25.1 % (95%CI 10.1 %–38.2 %; p &lt; 0.001) respectively when compared between dual vs triple sulbactam based antibiotic combination therapy.</div></div><div><h3>Conclusion</h3><div>Treatment with sulbactam, polymyxin B and minocycline combination antibiotic therapy was associated with significantly lower 28-day mortality. Moreover, the lower requirement of inotropes during treatment and a significant reduction in HsCRP level favours this combination antibiotic therapy in VAP caused by CRAB.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345833","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 novel case of Vibrio bacteremia in an immune-competent patient","authors":"Muzeer Ahmed ,&nbsp;Abdul Nafey Kazi ,&nbsp;Muhammad Ateeb Sheikh ,&nbsp;Fareeha Adnan ,&nbsp;Fivzia Farooq Herekar","doi":"10.1016/j.ijmmb.2024.100740","DOIUrl":"10.1016/j.ijmmb.2024.100740","url":null,"abstract":"<div><div>Vibrio Cholera, a gram negative bacterium, is notoriously known to cause diarrheal epidemics. The serotypes O1 and O139 are mainly responsible for the diarrheal outbreaks due to the enterotoxin they produce. This enterotoxin however seems to be protective against bacteremia and hence bacteremia is rarely encountered. We report a case of an immune-competent young female who initially presented with hypokalemic periodic paralysis secondary to acute on chronic diarrhea. She was discharged after rehydration and bounced back in septic shock and her blood cultures grew <em>Vibrio Cholera</em> identified on Vitek. She succumbed to this organism within 24 hours of re-admission.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365108","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":"Enhancing infection control in dialysis at a resource limited public healthcare institute: A cross-sectional study on microbiological quality assessment of dialysis water and dialysate","authors":"Swathi Suravaram ,&nbsp;Shreya Sri Gopikonda ,&nbsp;Imran Ahmed Siddiqui ,&nbsp;Harika Kanugula ,&nbsp;Dhanalakshmi Gorakanti ,&nbsp;Lakshmi Vaddanapu","doi":"10.1016/j.ijmmb.2024.100734","DOIUrl":"10.1016/j.ijmmb.2024.100734","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the microbiological quality of dialysis water and dialysate samples from hemodialysis units at a tertiary care government hospital and to assess the use of culture, endotoxin and periodicity of testing these assays to guide the actions of monitoring the quality of hemodialysis fluids, implement preventive and corrective actions, and improve the safety and outcomes of the dialysis process.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted at a 250-bedded super-specialty government hospital with a 24/7 hemodialysis unit equipped with 40 dialysis machines. Dialysis water and dialysate samples were collected monthly and analysed for microbial contamination and endotoxin levels as per AAMI guidelines. Bacterial cultures were done using Reasoner's Agar plates, and endotoxin analysis was performed using gel clot assay. Interpretation of results was based on predefined thresholds.</div></div><div><h3>Results</h3><div>Among the 740 samples processed for microbial culture 19.6 % and 80.4% were unacceptable and acceptable respectively.Among the acceptable samples 10.5 % were at action level. At the end of 2 days of incubation, 15.2%dialysis water samples and 5.1%dialysate samples had unacceptable levels of bacterial colonies and at 5days additional 10.6 % dialysis water samples and 7.7%dialysate samples were unacceptable. 21.5 % of the samples tested for endotoxin had unacceptable levels.</div></div><div><h3>Conclusions</h3><div>Regular monitoring of water quality in government healthcare hemodialysis units is crucial for quality of care, timely preventive and corrective actions for mitigating adverse outcomes. Processing cultures for 5–7 days is essential for detecting all contaminated specimens. While there might be a link between endotoxin levels and bacterial contamination, both endotoxin testing and bacterial culture independently are vital for evaluating water quality in dialysis settings. A comprehensive approach integrating various testing methods is necessary to uphold patient safety and enable necessary improvements.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345834","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":"Microbial profiling, antimicrobial resistance surveillance, and molecular detection of MecA gene in Staphylococcal strains from donor human milk: Insights from a milk bank investigation","authors":"Astha Yadav ,&nbsp;Sheetal Verma ,&nbsp;Vimala Venkatesh ,&nbsp;Amita Jain ,&nbsp;Mala Kumar ,&nbsp;Saurabh Kashyap ,&nbsp;Shalini Tripathi","doi":"10.1016/j.ijmmb.2024.100733","DOIUrl":"10.1016/j.ijmmb.2024.100733","url":null,"abstract":"<div><h3>Purpose</h3><div>Donor human milk (DHM) from milk banks provides vital nutrition to vulnerable infants. Understanding its microbial profile and antimicrobial resistance patterns is crucial for ensuring its safety and efficacy. This study aimed to profile the microbial composition, detect antibiotic resistance, and identify the presence of mecA gene in <em>Staphylococcal</em> strains from DHM samples.</div></div><div><h3>Materials and method</h3><div>A total of 151 DHM samples were collected from a regional human milk bank in North India. Microbial identification was performed using MALDI TOF MS, and antimicrobial susceptibility testing was conducted using the disc diffusion method. Molecular methods, including PCR, were employed for mecA gene detection.</div></div><div><h3>Results</h3><div>The study revealed a diverse microbial profile, with <em>Staphylococcus</em> species being predominant. <em>Acinetobacter</em> and <em>Pseudomonas</em> species were also prevalent, raising concerns due to their association with healthcare-associated outbreaks. High rates of antibiotic resistance were observed across both Gram-positive and Gram-negative bacteria, with resistance to commonly used antibiotics such as penicillin, clindamycin, erythromycin, and ceftriaxone. The mecA gene, associated with methicillin resistance, was detected in a significant proportion of <em>Staphylococcal</em> isolates.</div></div><div><h3>Conclusion</h3><div>The study underscores the importance of rigorous microbial analysis and antimicrobial susceptibility testing in assessing the safety of DHM. The presence of diverse microbial species, including antibiotic-resistant strains and the mecA gene in <em>Staphylococcal</em> strains, emphasizes the need for stringent hygiene practices and continuous surveillance in milk banks. Implementing comprehensive screening protocols and adhering to best practices in milk handling and pasteurization are crucial for safeguarding the health of vulnerable infants reliant on donor milk.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345835","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 systematic review and meta-analysis to develop a landscape map of antibiotic resistance for six WHO priority pathogens in east and north-east India from 2011 to 2022","authors":"Simran Malik ,&nbsp;Chetan Mahadev Shirvankar ,&nbsp;Rahul Kurian Jacob ,&nbsp;Debashree Guha Adhya ,&nbsp;Subir Sinha ,&nbsp;Sanjay Bhattacharya ,&nbsp;Kamini Walia ,&nbsp;Sangeeta Das Bhattacharya","doi":"10.1016/j.ijmmb.2024.100732","DOIUrl":"10.1016/j.ijmmb.2024.100732","url":null,"abstract":"<div><h3>Background</h3><div>Determining regional patterns of antimicrobial resistance in bacterial infections in the healthcare setting (AMR) identifies surveillance gaps and informs policies for mitigation. We estimated the prevalence of AMR for six WHO priority pathogens in diagnostic and surveillance samples in the twelve east and north-east Indian states from 2011 to 2022 (PROSPERO ID: CRD42021278961).</div></div><div><h3>Methods</h3><div>Studies were searched on Medline, Scopus, and Web of Science. Observational, descriptive, and cross-sectional studies, reporting AMR based on laboratory diagnostics, in individuals from east and north-east India from 2011 to 2022 were included. Four reviewers in pairs conducted abstract, full-text screening, and data extraction. We estimated the prevalence of resistance in fifty-four pathogen-antibiotic combinations, and six antibiotic resistance patterns. Pooled estimates of prevalence (Ɵ), heterogeneity (I²), and 95 % confidence intervals were calculated using the random effects model.</div></div><div><h3>Results</h3><div>Fifty-five studies were included. Information was available for nine states, none from Arunachal Pradesh, Mizoram, and Nagaland<em>. E. coli</em> was most frequently isolated (59.2 %, 95 % CI: 48.8–69.6 %), followed by <em>S. aureus</em> (36.2 %, 95 % CI: 20.2–52.2 %)<em>, Enterococcus</em> (27.5 %, 95 % CI: 11.2–43.7 %)<em>, Klebsiella</em> (25 %, 95 % CI: 15–35 %)<em>, Acinetobacter</em> (15.7 %, 95 % CI: 2.3–29.1 %), and <em>Pseudomona</em>s <em>aeruginosa</em> (15.7 %, 95 % CI: 4.1–27.3 %). There was high prevalence of ESBL (45 %, 95 % CI: 35–55 %) and carbapenem resistance (30 %, 95 % CI: 22–38 %). AmpC (23 %, 95 % CI: 9–37 %) and colistin resistance was lower (10 %, 95 % CI: 0–22 %) but supporting data was limited. Overall prevalence of MRSA was 26 % (95 % CI: 14–39 %), and VRE was 9 % (95 % CI: 0–17 %).</div></div><div><h3>Conclusion</h3><div>High prevalence of resistance was seen to all first-line antibiotics. Gram positive bacteria had high resistance to penicillins, and Gram negatives to third-generation cephalosporins, beta-lactam/beta-lactamase inhibitors, and carbapenems. Aminoglycoside, fluoroquinolone, and trimethoprim-sulphamethoxazole resistance was common across all genera. Critical regional AMR information gaps exist.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286075","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}