Indian Journal of Medical Microbiology最新文献

{"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":"52 ","pages":"Article 100738"},"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":"52 ","pages":"Article 100739"},"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":"52 ","pages":"Article 100737"},"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":"52 ","pages":"Article 100740"},"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":"52 ","pages":"Article 100734"},"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":"52 ","pages":"Article 100733"},"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":"52 ","pages":"Article 100732"},"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}

{"title":"A case report and literature review of nontuberculous mycobacterial disease caused by Mycolicibacter kumamotonensis","authors":"Ayano Watanabe ,&nbsp;Takehisa Sano ,&nbsp;Kenta Murayama ,&nbsp;Ryota Miyamoto ,&nbsp;Junya Kamei ,&nbsp;Toshihiro Masuda ,&nbsp;Suguru Kojima ,&nbsp;Kyoko Hijiya ,&nbsp;Masato Fujii","doi":"10.1016/j.ijmmb.2024.100731","DOIUrl":"10.1016/j.ijmmb.2024.100731","url":null,"abstract":"<div><p>Herein, we report a rare case of pulmonary nontuberculous mycobacterial (NTM) infection caused by <em>Mycolicibacter kumamotonensis</em> in a 73-year-old man successfully treated with clarithromycin, rifampicin, and ethambutol. Seven cases of NTM disease caused by <em>M. kumamotonensis</em> have been previously described, with characteristics differing from those of more common NTM diseases.</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100731"},"PeriodicalIF":1.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172603","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":"Next generation sequencing to detect pathogens causing paediatric community-acquired pneumonia - A systematic review and meta-analysis","authors":"Kiran Chawla ,&nbsp;Rosemary Shaji ,&nbsp;Nayana Siddalingaiah ,&nbsp;Sreenath Menon P K ,&nbsp;Sangeetha M D ,&nbsp;Leslie Edward S. Lewis ,&nbsp;Sharath Burugina Nagaraja","doi":"10.1016/j.ijmmb.2024.100730","DOIUrl":"10.1016/j.ijmmb.2024.100730","url":null,"abstract":"<div><h3>Background</h3><p>Paediatric community-acquired pneumonia (CAP) is a major public health challenge in children, requiring accurate and timely diagnosis of causative pathogens for effective antibiotic treatment. We aimed to explore the utility of next-generation sequencing (NGS) in precise diagnosis of pediatric CAP and its effect on treatment outcome of these children.</p></div><div><h3>Methods</h3><p>A systematic review and meta-analysis was conducted to compare NGS-guided antibiotic therapy with conventional methods in pediatric CAP. The study followed PRISMA guidelines and searched for electronic databases including PubMed/MEDLINE, Embase, Scopus, and Web of Sciences from 2012 to 2023. Studies on pediatric CAP (&lt;18 years) using NGS alongside conventional diagnostics, were included.</p></div><div><h3>Results</h3><p>Database search identified 721 studies and 6 were finally included for review, published between 2019 and 2023. Meta-analysis revealed an overall odds ratio of 2.39 (95 % CI 1.22, 3.56) for NGS vs conventional methods. Detection rates using NGS ranged from 86% to 100 %, surpassing conventional methods (26%–78.51 %). Five out of selected 6 studies (83.33 %) have documented that change in treatment based on NGS finding resulted in clinical improvement of patients. There was no significant heterogeneity and potential bias among the studies. Nearly 80 % of the studies were of good quality.</p></div><div><h3>Conclusion</h3><p>The NGS (particularly metagenomic sequencing) is a promising tool for diagnosing paediatric CAP with high accuracy. It can improve antibiotic usage practices and patient outcomes, potentially reducing antibiotic resistance. Based on meta-analysis, training of healthcare professionals in NGS methodologies and result interpretation is highly recommended.</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100730"},"PeriodicalIF":1.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0255085724002056/pdfft?md5=8166ddfa0c0d3241bf88c2a59b15d5ef&pid=1-s2.0-S0255085724002056-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The burden of tuberculosis among patients with non-small cell lung carcinoma in a tertiary care center","authors":"Niranjan Mahishi ,&nbsp;Kiran Bala ,&nbsp;Prabhat Malik ,&nbsp;Piyush Ranjan ,&nbsp;Arvind Kumar ,&nbsp;Manish Soneja ,&nbsp;Anant Mohan ,&nbsp;Urvashi B. Singh","doi":"10.1016/j.ijmmb.2024.100729","DOIUrl":"10.1016/j.ijmmb.2024.100729","url":null,"abstract":"<div><h3>Background</h3><p>Lung cancer and tuberculosis share similar risk factors, clinical spectrum, radiological features and it is difficult to differentiate but it is important to diagnose both conditions for targeted therapy and better outcome.</p></div><div><h3>Aims</h3><p>Our primary objective was to estimate the proportion of TB in primary biopsy proven non-small cell lung carcinoma (NSCLC) cases.</p></div><div><h3>Material &amp; methods</h3><p>This prospective observational study was conducted in the Departments of Medicine/Pulmonary Medicine/Medical Oncology and Microbiology at the All India Institute of Medical Sciences, New Delhi for a period of 2 years (January 2020–December 2021). Patients with biopsy proven, primary non-small cell lung cancer were recruited and sputum samples were subjected to microbiological investigations to confirm tuberculosis. Comparison was done in two groups of lung cancer patients with confirmed TB (Group A) and without confirmed tuberculosis (Group B).</p></div><div><h3>Results</h3><p>Total 75 patients with biopsy proven, primary NSCLC were recruited and 16 % (12/75) were diagnosed with confirmed TB. Adenocarcinoma (36.48 %) and Squamous cell carcinoma (33.44 %) were the two predominant histopathological subtypes of NSCLC. About 57 (76 %) of them were found to be in stage IV of Lung cancer at initial presentation itself (75 % in group A &amp; 74.6 % in group B; p value &lt; 0.80). A majority of patients (11/12 cases; 91 %) of group A were males with a mean age of 59 ± 7.5 years. The upper lobes of the lung were involved in 65 % (49/75) of the cases and showing a mass lesion on imaging (75 % in group A &amp; 65 % in group B; p value &lt; 0.52). Kaplan Meier survival revealed a median survival time of 11 months in subjects with only NSCLC and a median survival time of 4 months in the group with concomitant TB and NSCLC (p value &lt; 0.44).</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100729"},"PeriodicalIF":1.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119700","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}