College, Kottayam, for a period of one year from July 2015. The study design was Analytical Diagnostic Test Evaluation. The study was designed at comparing different phenotypic methods in their sensitivity, specificity, positive predictive value, negative predictive value and accuracy, keeping mec-A gene detection by PCR as the gold standard. The following six phenotypic methods were performed on Staphylococcus aureus isolates-Cefoxitin Disc Diffusion (CDD), Oxacillin Disc Diffusion (ODD), Oxacillin Screen Agar (OSA), Oxacillin E-Strip (ES), Chromogenic agar medium (ChromID® MRSA SMART-biomerieux) and VITEK-2 system (biomerieux). These were then compared with the gold standard method-mecA gene detection by PCR. RESULTSCefoxitin disc diffusion test and VITEK 2 system showed results in agreement with PCR (Sensitivity and specificity 100%). This was followed by Chrome agar (98.36%, 95.79%), Oxacillin screen agar (95.08%, 98.95%), Oxacillin E-test (95.08%, 97.89%) & Oxacillin disc diffusion test (81.96%, 97.89). CONCLUSIONSCefoxitin disc diffusion test which shows total agreement with PCR is a good surrogate marker for detecting methicillin resistance. However, VITEK-2 system and chromogenic agar media are valuable as they are useful in early detection and screening of MRSA.

A 62-year-old male presented to the Medicine Department with altered sensorium with a history of fever of unknown origin of 6 weeks duration. Initially, it was low-grade, on and off fever, which later got converted into high-grade fever with chills and rigors. No h/o cough, dysuria, loose stools, vomiting or headache. No h/o any surgeries in the past, bathing in open water bodies or wound which came in contact with soil (as the patient remembers of). He was a known case of diabetes and was on oral hypoglycaemics. He consulted a doctor in a local hospital and was started on oral amoxicillin and later referred to our hospital as he was not improving. On examination, vitals were stable. He was febrile and pale. Abdominal examination revealed mild abdominal tenderness. The examinations of other systems were unremarkable.

No abstract

No abstract

The SARS-CoV-2 Variant of Concern, Delta (B.1.617.2) was first reported in December 2020 in India and has spread colossally throughout the globe. Owing to factors like increased transmissibility, immune escape, and virulence, the delta variant has been considered as a potential public health threat apart from other variants of concern like alpha, beta and gamma. Kerala was one of the first states in India to enroll in the systematic genomic surveillance. In the present report, vaccine breakthrough infections were followed up in 147 patients including 55 healthcare workers who had been vaccinated with ChAdOx1 nCoV- 19/BBV152 across eleven districts from the state of Kerala. The timeline of samples analysed were from April 2021 till June 2021. Severity of the infections reported in the enrolled patients found to be mildly symptomatic, majorly with only 0.7% (n=1) of the cohort to be asymptomatic. Genomic analysis of the samples revealed the Delta variant (B.1.617.2) to constitute about 81.6% (n=120) in the studied cohort. This was followed by the Kappa variant B.1.617.1 (8.35%, n=9), AY.1 (0.6%, n= 1), AY.12 (0.6%, n= 1), AY.4 (1.2%, n= 2), AY.9 (1.2%, n= 2) and Eta variant, B.1.525 (0.6%, n= 1). 11 samples were not assigned any lineage. Evidence from this study suggests the preponderance of the Delta variant in the samples analysed.