Background: Rapid and accurate detection of methicillin resistant Staphylococcus aureus (MRSA) is an important role of clinical microbiology laboratories to avoid treatment failure. The aim of this study was to compare conventional methods against the cefoxitin disc diffusion method to determine the best phenotypic method. Methods: Study was carried out in the Department of Microbiology, National Institute of Medical Sciences & Research, Jaipur (India), between July 2016 – December 2016. The methods included were Oxacillin E-test MIC, Oxacillin screen agar, Oxacillin disk diffusion, Cefoxitin disk diffusion and CHROMagar- MRSA methods. Antimicrobial susceptibility performed as per CLSI guidelines.Results: Out of 142 isolates of S. aureus, fifty three (37.32%) strains of MRSA were isolated from clinical specimen. E-MIC test was selected as gold standard method. The sensitivity and specificity of Oxacillin screen agar and CHROMagar-MRSA were same 98.07% and 97.80%, respectively. The sensitivity and specificity of oxacillin disk diffusion were 94.23% and 98.89%. Fifty three strains of S. aureus were MRSA by cefoxitin disk diffusion method and Oxacillin Ezy MIC test. The sensitivity and specificity of cefoxitin disk diffusion method and Oxacillin Ezy MIC method was 100% and 100% respectively. All isolates including MRSA were susceptible to Vancomycin and Linezolid. Conclusions: All phenotypic methods had high sensitivity and specificity for detection of MRSA. However, cefoxitin disk diffusion method in comparison to other methods had higher sensitivity and specificity.
Candida albicans remains the most frequently isolated species, but an increase in the prevalence of Non-albicans candida is a matter of concern for 1-3 various laboratories, as NAC show less susceptibility to antifungal agents particularly azoles . Routinely used conventional methods are cumbersome and time consuming. Hence the present study aimed at species identication of candida isolated from various clinical specimens and also to evaluate the usefulness of HiCrome Candida differential agar as compared to routine conventional method for speciation of candida. A total of 51 non repetitive clinical isolates of Candida were obtained from various clinical samples. Candida albicans was the major species accounting for 23 (45.10%) of the total isolates. Non albicans Candida constituted 17 (33.33%) of C. tropicalis, 9 (17.64%) of C. krusei and 2 (3.92%) of C. parasilosis. 49 Candida species which were correctly identied by HiCrome Candida agar except 2 species of C.parasilosis (identied by conventional method) which were identied as C. glabrata by Hicrome Candida agar.
INTRODUCTION: Venereal Disease Research Laboratory (VDRL) test is performed by the physicians to screen patients for syphilis and is still the most commonly used test all over the world for screening. Three basic methods has been described in screening for syphilis. These include direct observation of the T. pallidum by dark field microscopy, and nontreponemal and treponemal serologic antibody studies. Nonspecific (non tremonemal) tests like Venereal Disease Research Laboratory (VDRL) test use lipoidal antigens containing cardiolipin, lecithin, and cholesterol, that flocculate with IgM and IgG. Positive tests occur from 21 days of exposure till about up to 6 weeks after infection. Serologic tests in syphilis only provide indirect evidence of syphilis and may be reactive in the absence of clinical or epidemiologic evidence of syphilis. The reactivity in these cases is usually in low dilutions (<1:8), however, in exceptional cases false reactivity is shown in very high titers up to 1:256. False-positive reactions can also also be seen with treponemal tests. MATERIAL AND METHODS: A total of 10253 patients were tested for syphilis by VDRL as a screnning test during study period. Both the the qualitative and quantitative VDRL tests were done as per the manufacturer's instructions. TPHA was performed on all the sera demonstrating reactivity with VDRL test. VDRL test was based on the principle that after syphilis infection, host develops nontreponemalantilipoidal antibodies in response to the release of lipoidal material from the damaged host cells. Also host produces antibodies against T. pallidum. In TPHA Agglutination of cells shows a positive reaction. In the absence of antibody i.e. in negative cases cells settled down to form a compact button in the well which constituted a negative reaction. RESULTS: In this study a total of 10253 patients were screened for syphilis by VDRL of which 98 were reactive. In a sample of 98 VDRL reactive patients, 33(34%) were males and 65(66%) females. The age of patients who tested VDRL positive in our study ranged from youngest being 21 years to eldest being 66 years. Majority of patients i.e. 88.8% belonged to 20-50 years of age group, with majority of patients 37.75% belonging to age group 30 – 40. CONCLUSION: VDRL test is the best screening test for the diagnosis of syphilis but whenever the patient is serologically reactive it should be confirmed by the more specific TPHA test.
Scrub typhus is a rickettsial disease caused by the organism Orientia tsutsugamushi. The overall mortality varies from 7% to 30%, next only to malaria among infectious diseases5. This prospective study was conducted with an aim to know the prevalence of the disease, sex ratio signicance and impact of seasons in the disease outcome in Rajsamand, Rajasthan. A total of 515 samples were received from different clinical departments at Ananta Institute of Medical Sciences and research center, Rajsamand from December 2020-December 2021, in which 88 samples were IgM Antibody reactive by Rapid card test and positivity is 16.7%. Scrub typhus infection was found comparatively more in female patients i.e., 48[55%] than in male patients 40 [45%]. The female to male ratio was 1.2:1. In the present study, majority of the patients 29 (32%) were from the age group of 31-45 yrs and about 19 (22%) were between 16-30 yrs. Maximum cases 31(35%) had occurred in the month of September followed by 27(31%) in October, 21(24%) in November and 4(5%), 3(3%), 2(2%) in the month of August, July and December 2021 respectively and not a single case reported in the month of December 2020 and from January 2021 to June 2021. So, scrub typhus should always be considered in the list of differential diagnosis of a young febrile female patient of this region mainly during the end of rainy season. This will help in proper diagnosis, timely and adequate treatment and avoidance of complications which are associated with high mortality
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