Indian Journal of Medical Microbiology最新文献

{"title":"Molecular characterisation of fosfomycin resistant Enterococci faecalis isolated from a tertiary care medical hospital in northern India","authors":"Anjum Ara Mir,&nbsp;Sayim Wani,&nbsp;Nargis Bali,&nbsp;Bisma Ahad,&nbsp;Masooma Showkat,&nbsp;Aarifa Bashir","doi":"10.1016/j.ijmmb.2025.101022","DOIUrl":"10.1016/j.ijmmb.2025.101022","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the in-vitro activity of fosfomycin in urinary isolates of <em>Enterococcus faecalis</em> and look for the molecular mechanisms responsible for resistance to this antibiotic.</div></div><div><h3>Methods</h3><div><em>E. faecalis</em> isolates recovered from urine samples were processed for the presence of genes encoding the FOS modifying enzymes, <em>fosA, fosB, fosC, fosX</em> and <em>murA</em>. DNA was extracted using QIAamp DNA Mini kit. Conventional PCR using forward and reverse primers targeting the five genes was carried out. The amplified products were electrophoresed and visualized in a gel documentation system. Antimicrobial susceptibility testing was done by disc diffusion method.</div></div><div><h3>Results</h3><div>A total of 274 isolates of <em>E. faecalis</em> isolates were part of our study out of which 57 (20.8 %) were FOS resistant. Slightly more number of FOS resistant isolates were recovered from female patients, 30 (52.6 %) and from patients in the age group of &gt;39 yrs. Majority of the FOS resistant isolates were recovered from patients attending the OPD. Vancomycin resistance was seen in 69 (25.2 %) <em>E. faecalis</em> isolates. <em>fosB</em> was was the most common gene, present in 42 (73.7 %) isolates and <em>murA</em> was present in 15 (26.3 %) isolates of <em>E. faecalis</em>. Furthermore all the FOS resistant, vancomycin resistant isolates harboured the <em>fosB</em> gene (n = 26).</div></div><div><h3>Conclusion</h3><div>To our knowledge this study is the first to explore FOS resistance in <em>E. faecalis</em> isolates from this part of the country. Increased resistance to FOS as compared to what has been reported previously calls for strict implementation of infection control protocols as well as heightened surveillance studies.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101022"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563836","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":"Whole-genome sequence analysis of cefiderocol-resistant E. coli and Klebsiella pneumoniae isolates from cefiderocol treatment-naïve patients","authors":"Gayatree Nayak ,&nbsp;Naveen Kumar Devanga Ragupathi ,&nbsp;Bijayini Behera","doi":"10.1016/j.ijmmb.2025.101025","DOIUrl":"10.1016/j.ijmmb.2025.101025","url":null,"abstract":"<div><div>Cefiderocol (FDC) is regarded as a reserved therapeutic option for serious CRE infections. In an earlier study, we had reported a 9.9 % FDC resistance in CRE isolates. In the present study, we are reporting the whole genome sequencing analysis findings of two FDC-resistant CRE (One <em>E. coli</em> and one <em>K. pneumoniae</em>). PBP3 insertions and mutations in the siderophore receptor <em>cirA</em> were the primary drivers of FDC resistance in <em>E. coli</em>. In <em>K. pneumoniae</em>, there was intact porin and a single copy of <em>bla</em>_NDM-5, and a combination of β-lactamase and carbapenem resistance genes, including <em>bla</em>_{TEM- 1B}, <em>bla</em>_CTX-M-15, <em>bla</em>_NDM-5 and <em>bla</em>_OXA-181.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101025"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563814","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":"Clinical and genotypic spectrum of SDSE from a tertiary Indian centre: Diversity, virulence, and AMR trends","authors":"K. Kirubanandan,&nbsp;Rosemol Varghese,&nbsp;Binesh Lal Y,&nbsp;Ayyanraj Neeravi,&nbsp;Subbulakshmi R,&nbsp;Balaji Veeraraghavan","doi":"10.1016/j.ijmmb.2025.101041","DOIUrl":"10.1016/j.ijmmb.2025.101041","url":null,"abstract":"<div><h3><em>Streptococcus dysgalactiae</em> subsp</h3><div><em>equisimilis</em> (SDSE) is an emerging pathogen with similarities to <em>S. pyogenes</em>, with limited Indian molecular epidemiological data. This study characterized 55 SDSE isolates via MALDI-TOF and whole genome sequencing for <em>emm</em> typing, MLST, virulence, and antimicrobial resistance profiling. Infections mainly affected diabetic males (mean age 44), commonly presenting as cellulitis or non-healing ulcers. sixteen <em>emm</em> types and 17 STs were identified; with all isolates carrying virulence genes <em>lmb</em>, <em>slo</em>, <em>sagA</em>. The isolates were 100 % penicillin susceptible and 42 % macrolide non susceptible with 53 % <em>mef(A)</em> and 35 % <em>msr(D).</em> Findings stress the need for region-specific genomic surveillance.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101041"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145786865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic plasticity of Escherichia coli causing bloodstream infections in India: A focus on phylogroups A to F","authors":"Karthik Gunasekaran ,&nbsp;Irulappan Madhumathi ,&nbsp;Santhosh Raj ,&nbsp;Greesma Grace Thomas ,&nbsp;Venkatesh Narashiman ,&nbsp;Vishnukumar Ramesh ,&nbsp;Subbulakshmi Rajendran ,&nbsp;Ramprakash Rayala ,&nbsp;Ayyanraj Neeravi ,&nbsp;Binesh Lal ,&nbsp;Kamini Walia ,&nbsp;Balaji Veeraraghavan","doi":"10.1016/j.ijmmb.2025.101026","DOIUrl":"10.1016/j.ijmmb.2025.101026","url":null,"abstract":"<div><h3>Background</h3><div><em>Escherichia coli</em> is a major pathogen in bloodstream infections (BSIs), with increasing concern over antimicrobial resistance (AMR) and the evolving pathogenic potential of phylogroups traditionally considered commensal. This study investigates the genetic characteristics of <em>E. coli</em> isolates causing BSIs in India, with a focus on phylogroups A to F.</div></div><div><h3>Methods</h3><div>204 <em>E. coli</em> bloodstream isolates received at a tertiary hospital in India were whole genome sequenced. Phylogroups, sequence types (STs), antimicrobial resistance genes (ARGs), virulence factors (VFs), and plasmid replicon types were determined. Bioinformatics analyses include MLST, ResFinder, VirulenceFinder, PlasmidFinder, and ClermonTyping for phylogroup assignment.</div></div><div><h3>Results</h3><div>Phylogroup B2 (35 %) was the most prevalent, followed by phylogroup A (32 %) and D (19 %). ST131 (B2) emerged as the dominant clone (22 %). Phylogroup A isolates, previously considered commensal and primarily associated with high AMR, now demonstrated notable acquisition of virulence factors such as <em>fimH</em> and <em>iutA</em>, indicating an emerging role as significant BSI pathogens. These isolates also showed high clonal diversity (e.g., ST167, ST410, ST617). Key resistance genes included blaCTX-M (53 %) and blaTEM (25 %), frequently associated with IncF plasmids. Multi-replicon plasmid profiles, particularly IncF variants, were significantly associated with co-carriage of both AMR and VF genes, contributing to enhanced pathogenicity.</div></div><div><h3>Conclusion</h3><div>This study highlights the emerging role of phylogroup A <em>E. coli</em>, traditionally commensal and AMR-rich as a leading cause of BSIs in India following the acquisition of virulence factors. In parallel, B2 clones like ST131 continue to drive infections through their established virulence and resistance repertoire. Such multi-replicon IncF plasmids driving AMR–VF co-selection, calls for focused surveillance and intervention in <em>E. coli</em> BSIs.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101026"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145587295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quiescent non-union: Acknowledging a discrete entity and comparing serological markers for diagnosis of infection at non-union site","authors":"Sandeep kumar Chaudhari ,&nbsp;Mohit Dhingra ,&nbsp;Mohit Bhatia","doi":"10.1016/j.ijmmb.2026.101044","DOIUrl":"10.1016/j.ijmmb.2026.101044","url":null,"abstract":"<div><h3>Background</h3><div>Quiescent non-union refers to a state where a fracture fails to heal, and the site appears clinically inactive despite the possible presence of a dormant or low-grade infection. This condition often follows open fractures or prior surgical interventions. Although typical signs of infection—pain, swelling, or discharge—are absent, latent infections may reactivate, leading to severe complications. Diagnosing infection in such cases is challenging due to the lack of definitive tools, and clinicians typically rely on inflammatory markers like C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and total leukocyte count (TLC), though their reliability remains uncertain.</div></div><div><h3>Objective</h3><div>To determine the prevalence of infection in patients with quiescent non-union of long bone diaphyseal fractures and evaluate the diagnostic performance of various microbiological and serological tests.</div></div><div><h3>Methodology</h3><div>This cross-sectional study was conducted at a tertiary care centre from December 2019 to January 2022, involving 50 patients with long bone non-unions. Radiographs classified non-union types. Intraoperatively, four tissue samples (from bone ends and surrounding soft tissue) were collected for microbiological analysis. Preoperative blood samples assessed TLC, ESR, and CRP levels.</div></div><div><h3>Results</h3><div>Of 50 patients, 10 (20 %) had positive microbial cultures. Among serological tests, TLC had 20 % sensitivity and 56 % accuracy; ESR had 40 % sensitivity and 64 % accuracy. CRP demonstrated the highest sensitivity (60 %) and diagnostic accuracy (76 %).</div></div><div><h3>Conclusion</h3><div>Occult infection may be present in quiescent non-unions. CRP is the most reliable serological marker for detecting such hidden infections.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101044"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145920941","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":"Antimicrobial resistance in blood culture proven sepsis in outborn and inborn neonates","authors":"Alisha Mahajan ,&nbsp;Varsha Gupta ,&nbsp;Suksham Jain","doi":"10.1016/j.ijmmb.2025.101023","DOIUrl":"10.1016/j.ijmmb.2025.101023","url":null,"abstract":"<div><h3>Background</h3><div>Neonatal sepsis is a major cause of mortality and morbidity, representing a critical emergency that demands swift diagnosis and intervention. Recent trend shows increasing resistance to commonly used antibiotics.</div></div><div><h3>Aims and objectives</h3><div>To study the antimicrobial resistance pattern in blood culture positive neonatal sepsis in outborn and inborn neonates and to compare the clinical profile in neonates with proven sepsis.</div></div><div><h3>Methods</h3><div>Bacterial cultures of the blood samples received from neonates with suspected sepsis was performed and antimicrobial susceptibility testing of blood culture positive neonates was done. Antibiotic sensitivity tests were done as per Clinical and Laboratory Standards Institute (CLSI) 2023 guidelines.</div></div><div><h3>Results</h3><div>Of the 100 participants, 34 were early onset neonatal sepsis and 66 were late onset neonatal sepsis. 35 % of the delivery were vaginal whereas 65 % of the deliveries were by Caesarean section. 17 % of the total neonates delivered had to undergo neonatal resuscitation and 36 % of the neonates had birth asphyxia. The most commonly isolated organisms were Coagulase-negative Staphylococcus species (CoNS) (30 %) followed by <em>Klebsiella pneumoniae</em> (21 %) and <em>Acinetobacter baumannii complex</em> (20 %). 45.1 % were Extended Spectrum beta lactamase (ESBL) producers and 58 % were AmpC beta lactamases producers.</div><div>Case fatality rate was highest with <em>Klebsiella pneumoniae</em> i.e. 34.6 % followed by <em>Acinetobacter baumannii complex</em> i.e. 23.07 %.</div></div><div><h3>Conclusion</h3><div>Increase in antibiotic resistance organisms can lead to an increase in the neonatal case fatality rate (CFR), so regular surveillance is needed. Comparison between the resistance profile between inborn and outborn neonates provides an insight into the difference in the variety of organisms isolated and also the difference in resistance shown by community acquired and hospital acquired organisms.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101023"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573097","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":"Prevalence of Chlamydia trachomatis, Ureaplasma spp., Mycoplasma hominis and Mycoplasma genitalium in patients with sterile pyuria","authors":"Anivita Aggarwal ,&nbsp;Debasish Biswal ,&nbsp;Jyoti Rawre ,&nbsp;Naval Vikram ,&nbsp;Naveet Wig ,&nbsp;Manish Soneja ,&nbsp;Sreenivas Vishnubhatla ,&nbsp;Benu Dhawan","doi":"10.1016/j.ijmmb.2025.101030","DOIUrl":"10.1016/j.ijmmb.2025.101030","url":null,"abstract":"<div><h3>Introduction</h3><div>Sterile pyuria poses a diagnostic challenge due to varied aetiologies. Atypical pathogens including <em>Chlamydia trachomatis</em> and genital mycoplasmas are considered etiological agents but are under-reported, especially in resource-limited settings. This study determined the prevalence of these atypical pathogens in sterile pyuria patients.</div></div><div><h3>Materials and methods</h3><div>This 4-year prospective observational study screened 640 adults admitted to Medicine wards of a tertiary care hospital for sterile pyuria, defined as urine microscopy showing &gt;10 WBCs/HPF with no bacterial growth on culture. All sterile pyuria patients were evaluated for <em>Chlamydia trachomatis</em> (CT), <em>Ureaplasma</em> spp., <em>Mycoplasma hominis</em> (MH) and <em>Mycoplasma genitalium</em> (MG) from first void urine samples. <em>Mycoplasma hominis</em> and <em>Ureaplasma</em> spp. were detected by culture and PCR assay. <em>Chlamydia trachomatis</em> was detected by PCR assay. <em>Mycoplasma genitalium</em> was detected by Real-time PCR assay. Additional assessments for other potential causes were carried out. Patients were treated with doxycycline or azithromycin and followed for outcomes. Risk factors for infection with these atypical agents were explored.</div></div><div><h3>Results</h3><div>Of 640 patients screened, 100 (15.6 %) had sterile pyuria. Atypical pathogens were detected in 40 %. CT, <em>Ureaplasma</em> spp., and MH were detected in 19 %, 15 % and 5 % respectively. One patient tested positive for MG. Multivariate logistic regression identified multiple sexual partners (adjusted OR 12.01, 95 % CI 2.07–69.40, p = 0.005) and past pelvic surgery (adjusted OR 5.64, 95 % CI 1.43–22.24, p = 0.013) as risk factors. Twenty-five (62.5 %) of 40 patients achieved complete clinical and microbiological cure with treatment. Laboratory records revealed genitourinary tuberculosis in 2 patients.</div></div><div><h3>Conclusion</h3><div>This study identified 40 % prevalence of atypical pathogens in sterile pyuria patients. Unlike previous assumptions, genitourinary tuberculosis was not a common cause in our population. Our findings emphasize the necessity for comprehensive screening for CT, <em>Ureaplasma</em> spp., MH, and MG in sterile pyuria patients.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101030"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aims and Scope","authors":"","doi":"10.1016/S0255-0857(26)00015-0","DOIUrl":"10.1016/S0255-0857(26)00015-0","url":null,"abstract":"","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101057"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420640","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":"Catheter-related bloodstream infection by Kocuria rhizophila in a dialysis patient","authors":"Aditi Gupta ,&nbsp;Nithya S. Roy ,&nbsp;Vibhor Tak ,&nbsp;Manish Chaturvedy","doi":"10.1016/j.ijmmb.2025.101029","DOIUrl":"10.1016/j.ijmmb.2025.101029","url":null,"abstract":"<div><div>Catheter related bloodstream infections are a common concern in hospitalized and immunocompromised patients. We report a case of CKD with an indwelling left IJV Permacath who developed fever and chills during dialysis. Investigations showed leukocytosis, elevated CRP (75 mg/L), and procalcitonin (9.1 ng/mL). Paired blood cultures grew <em>Kocuria rhizophila</em>, identified by MALDI-TOF, with a two-hour difference in positivity indicating CRBSI. Vancomycin led to improvement and antibiotic lock therapy was initiated. This case highlights that rare organisms such as <em>K. rhizophila</em> can be true pathogens in dialysis patients, and correct identification with MALDI-TOF alongside clinical correlation is crucial for appropriate management.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101029"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First autochthonous case of cutaneous leishmaniasis from Gujarat—a non-endemic area in India","authors":"Keyur Shah ,&nbsp;Sanjeev Shah ,&nbsp;Apurva Puvar ,&nbsp;Atul Patel","doi":"10.1016/j.ijmmb.2025.100958","DOIUrl":"10.1016/j.ijmmb.2025.100958","url":null,"abstract":"<div><div>Cutaneous leishmaniasis is endemic in more than 98 countries, and in India it was described in the Thar Desert in Rajasthan and parts of the Gangetic Plain. Many other states, notably Kerala, Jammu and Kashmir, Himachal Pradesh, and others, have been emerging endemic foci for cutaneous leishmaniasis in India. We are reporting the first autochthonous case of cutaneous leishmaniasis and adding the state of Gujarat to this list of emerging endemic areas for cutaneous leishmaniasis. This case will emphasise the need for clinical suspicion and diagnostic workup in patients presented with plaques over exposed body areas in Gujarat.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"58 ","pages":"Article 100958"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020418","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}