Indian Journal of Public Health Research & Development

Harit ¹, Varsha A. Singh ², Sonia Mehta ³, Shavi Nagpal ³, Rosy Bala ³, Dipankar Biswas ⁴

Affiliations
1 Tutor, Department of Microbiology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana, IN
2 Professor, Department of Microbiology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana, IN
3 Assistant Professor, Department of Microbiology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana, IN
4 Tutor, Department of Microbiology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana, IN

Abstract

Background: Tuberculosis (TB) is a leading cause of morbidity and mortality worldwide, despite being a treatable and preventable disease. The emergence of Multi Drug Resistant (MDR) TB had exacerbated the situation further. To prevent the spread of infection & to accelerate the administration of Anti-tubercular treatment, early detection of TB is required. Methodology: This Cross-sectional study was carried out on 236 samples clinically suspected cases of Pulmonary & Extra-Pulmonary Tuberculosis processed for Direct Ziehl-Neelsen Staining, Decontamination by NALC-NaOH and Culture in MGIT tubes & Lowenstein-Jensen Medium. Results: Out of 60 samples, 60(25.42%) were culture positive cases showed highest isolation rate by BACTEC MICRO MGIT as compared to LJ Medium 42(17.79%) with time of detection by BACTEC MICRO MGIT was 17 days and LJ Medium was 33.72 days. The Diagnostic accuracy of BACTEC MICRO MGIT when LJ Medium considered to be gold standard was also exhibited which showed sensitivity of 95.24%, Specificity of 89.69% while Negative Predictive value (NPV) & Positive Predictive value (PPV) was 98.86% and 66.67% respectively. The BACTEC MICRO MGIT detects mycobacteria early, with less contamination rates and has good sensitivity & specificity as compared to LJ Medium. Conclusion: So it can be concluded that BACTEC MICRO MGIT can be used as method of isolation of Mycobacterium tuberculosis either alone or in combination with LJ Medium.

Keywords

Tuberculosis, Pulmonary, Extra-Pulmonary, Lowenstein-Jensen Media, Mycobacterial.

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Pankaj Saini ¹, Varsha A. Singh ², Kunal Sharma ³, Gunjeet Singh ³, Abhishek Chauhan ⁴, Shailja Sharma ⁵

Affiliations
1 Junior Resident, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
2 Professor, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
3 Junior Resident, Department of Pharmacology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
4 Junior Resident, Department of Respiratory Medicine, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
5 General Physician, Baghpat, Uttar Pradesh, IN

Abstract

Non-tuberculous mycobacterium (NTM) has been identified in human pulmonary and extra pulmonary diseases and is of great concern for clinicians and microbiologists because of their increasing global incidence. They are now increasingly recognized as important pathogens in both immunocompromised and immunocompetent population. They should be identified rapidly and should be carefully differentiated as contamination, colonization ordisease. Cultures were made on conventional LJ and LJ with PNB media. Growth was confirmed as AFB (acid fast bacilli) by ZN staining. NTM were identified by growth on LJ with PNB media, colony morphology, rate of growth, pigmentation, catalase activity and confirmed by MPT 64 antigen rapid test (using SD Bioline TB Ag MPT 64 test kit) . Data was analysed statistically using SPSS software. Out of total 500 processed samples (250 pulmonary & 250 extrapulmonary), 12(21.05%) and 7(21.8%) NTM were isolated from pulmonary and extrapulmonary samples respectively. Maximum pulmonary NTM (41.7%) were isolated from > 60 years age of patients in contrast to extrapulmonary NTM isolates which were more in 20-40 years of age group. There was 16.7% previously treated patients in pulmonary while 100% were newly diagnosed patients in extrapulmonary TB cases. This study highlights the importance of early diagnosis and differentiation among Mycobacterium tuberculosisand NTM so that these NTM are not underestimated in routine diagnostic procedures merely as environmental or laboratory contaminants.

Keywords

Non-tuberculous mycobacterium, p-nitrobenzoic acid, Pulmonary TB, extrapulmonary TB, MPT64 antigen.

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Pankaj Saini ¹, Varsha A. Singh ², Pottathil Shinu ³

Affiliations
1 Junior Resident, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, IN
2 Professor,Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, IN
3 Assistant Professor, Department of Biomedical Sciences, College of Clinical Pharmacy, King Faisal University, Al Ahsa, 31982, SA

Abstract

Background: Culture remains the gold standard for the diagnosis of urinary tract infections (UTIs). However, the diagnosis of UTIs can be potentially enhanced when clinical characteristics of UTI, pyuria and bacteriuria are considered. Methodology: To evaluate the relationship between pyuria, bacteriuria and clinical characteristics with culture, un-centrifuged urine samples (N=817) were subjected to direct wet mount, direct Gram staining and semi-quantitative culture and the results were compared. Results: The direct wet mount and direct gram staining showed an overall sensitivity, specificity, positive predictive value and negative predictive value of 11.08%, 88.88%, 87.96%, 29.28% and 34.21%, 96.55%, 91% and 38.89%, respectively, as compared to semi-quantitative culture. Alternatively, the overall sensitivity, specificity, positive predictive value and negative predictive value of clinical characteristics of both upper and lower UTIs (most sensitive and specific symptoms combined) were found to be 55.14%, 76.06%, 71.29%, 31.47%, respectively. Conclusion: Both the direct wet mount and direct Gram staining could be considered as screening tests for diagnosis of UTI due to its low sensitivity and high specificity. However, integrated approaches wherein clinical characteristics of UTI combined with culture results would be of high diagnostic value in the diagnosis of UTI.

Keywords

Urinary tract infection, significant bacteriuria, pyuria, semi quantitative urine culture.

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Nitasha Kumari ¹, Ritu Garg ², Varsha A. Singh ³, Ashma Khatun ¹

Affiliations
1 M.Sc. Student, Department of Microbiology, Maharishi Markandeshwar Institute of Medical Sciences & Research, MMDU, Mullana, Ambala (Haryana), IN
2 Associate Professor, Department of Microbiology, Maharishi Markandeshwar Institute of Medical Sciences & Research, MMDU, Mullana, Ambala (Haryana), IN
3 Professor and Head, Department of Microbiology, Maharishi Markandeshwar Institute of Medical Sciences & Research, MMDU, Mullana, Ambala (Haryana), IN

Abstract

Background: Parasitic infections are the major public concern particularly in developing countries like India. Routinely used microscopy method for the detection of parasitic infections have compromised sensitivity. Materials and Method: The study was carried out on 500 stool samples received in Department of Microbiology MMIMSR, Mullana (Haryana) for a period of 6 months (August 2017 to January 2018). Stool samples for detection of ova and cyst were included. Result: Of these 500 samples examined, 235 (47%) stool samples showed positive results for ova/cyst after the use of simple salt floatation technique while it was merely 33% (n-165) without using the salt floatation method. of the 235 positive samples 29.8% were cyst of Giardia lamblia followed by eggs of Ascarislumbricoides (Fertilized and unfertilized) and cyst of Entamoebahistolytica each of 19.1%, Ancylostomaduodenale 14.9%, Hymenolepis nana 10.6%, Entamoeba coli 4.2% and Trichuristrichiura 2.1% were also identified. Conclusion: There is a need for more tests that do not sacrifice sensitivity and that can be used in poor resource field settings.

Keywords

Parasitic infection diagnosis, Ova/cyst, stool samples.

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Nitin Gupta ¹, Rosy Bala ², Varsha A. Singh ³, Harit Kumar ⁴, Shavi Nagpal ², Sonia Mehta ³

Affiliations
1 Assistant Professor, Department of General Medicine, M.M. Institute of Medical Sciences and Research, Mullana, Maharishi Markandeshwar (Deemed to be University), IN
2 Assistant Professor, Department of Microbiology, M.M. Institute of Medical Sciences and Research, Mullana, Maharishi Markandeshwar (Deemed to be University), IN
3 Professor, Department of Microbiology, M.M. Institute of Medical Sciences and Research, Mullana, Maharishi Markandeshwar (Deemed to be University), IN
4 Tutor, Department of Microbiology, M.M. Institute of Medical Sciences and Research, Mullana, Maharishi Markandeshwar (Deemed to be University), IN

Abstract

Over the years we have seen many antibiotics have been developed, each one supposedly better than the previous, but still we have not been able to overcome the persistent problem of antibiotic resistance regardless of the potency of the drug. There is an urgent need to develop new antibiotic strategies to overcome this problem that is different from previous efforts. Hence a method should be focused on the area of inhibition of bacterial evolution for resistance-“evolution proof Antibiotics”.

Keywords

Antibiotics, miracle molecules, Anti microbial resistance (ARM), Evolution proof molecules, evolvability factor.

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Shavi Nagpal ¹, Varsha A. Singh ², Harit Kumar ³, Aditi Pandey ⁴, Sonia Mehta ², Rosy Bala ¹

Affiliations
1 Assistant Professor, Department of Microbiology, MMIMSR, Maharishi, Markandeshwar (Deemed to be) University (MMDU), Mullana (Ambala), Haryana, IN
2 Professor, Department of Microbiology, MMIMSR, Maharishi, Markandeshwar (Deemed to be) University (MMDU), Mullana (Ambala), Haryana, IN
3 Tutor, Department of Microbiology, MMIMSR, Maharishi, Markandeshwar (Deemed to be) University (MMDU), Mullana (Ambala), Haryana, IN
4 M.Sc. Medical Microbiology, Department of Microbiology, MMIMSR, Maharishi, Markandeshwar (Deemed to be) University (MMDU), Mullana (Ambala), Haryana, IN

Abstract

Introduction: Diabetic wound infections is a dreaded complication of diabetes and often the leading cause of hospitalization for patients with diabetes worldwide. Infection if not treated timely and properly can even lead to amputation of the infected part. The present study was conducted as an attempt to evaluate the different microorganisms infecting diabetic wounds and to find out the antibiotic susceptibility patterns. Material and Method: A total of 128 patients of diabetic wound infections were included in this study from September 2018 to August 2019. Samples were processed as per standard guidelines, the microorganisms (bacterial and fungal) were isolated and further antibiotic susceptibility pattern for bacterial isolates was studied. Results: Out of 128, 106 (82.82%) yielded growth of microorganisms on culture. Predominance of bacterial growths (73.58%) as a causative etiology in diabetic wound infections were noticed over fungal (26.42%). Gram positive bacterial growths accounted to 39.74%, whereas 60.27% were gram negative growths. Staphylococcus aureus (29.49%) was the most predominant organism isolated, followed by Escherichia coli (25.64%) and Pseudomonas aeruginosa (24.36%). of the Staphylococcus aureus, 73.92% were methicillin resistant while 72.34% among gram negative isolates were ESBL producers with Escherichia coli accounting the highest degree of ESBL production. Linezolid, vancomycinandteicoplanin were the most sensitive drugs for Staphylococcus aureus and Gram‑negative isolates were mostly sensitive to imipenem based on our susceptibility results. Candida species (89.28%) was noted to be the most dominant fungal pathogen in diabetic wound infections. Conclusion: A good knowledge about the microbiological profile of diabetic wound infections and antimicrobial susceptibility patterns of the isolates can be helpful in guiding the clinicians to promptly and effectively treat diabetic wound infections.

Keywords

Diabetic wound infections, Bacterial isolates, Fungal isolates, Antimicrobial Susceptibility, Extended spectrum beta-lactamase (ESBL), Methicillin resistant staphylococcus aureus (MRSA).

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Sakshi Dalal ¹, Sonia Mehta ², Shinu Pottathil ³, Varsha A. Singh ², Shavi Nagpal ⁴

Affiliations
1 B.Sc. M.Sc. Medical Microbiology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana Ambala, Haryana, IN
2 Professor, Department of Microbiology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana Ambala, Haryana, IN
3 Assistant Professor, Department of Biomedical Sciences, College of Clinical Pharmacy, King Faisal University, Al Ahsa, 31982, SA
4 Assistant Professor, Department of Microbiology, Department of Microbiology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana Ambala, Haryana, IN

Abstract

Introduction: The ability to form bio-film is a universal trait of bacteria by attaching to the surfaces. Carbapenem resistance in Enterobacteriaceae might be endorsed by bio-film formation which augmented colonization of pathogens. Aim: To correlate between bio-film formation and carbapenem resistant Enterobacteriaceae isolates obtained from various clinical specimens and to compare the qualitative and quantitative assay for bio-film production. Method: Study was conducted on 150 strains of Enterobacteriaceae isolates. of these, carbapenem resistant Enterobacteriaceae isolates were subjected for bio-film formation by Modified Congo red agar method, tube adherence method and Tissue culture plate method. Results: Carbapenem resistant Enterobacteriaceae strains were found to be 60.66% and the rate of biofilm producers was 75.53% by any of the phenotypic method. Tissue culture plate method was found to be (67.6%) better than Modified Congo Red agar method (54.9%) and Tube adherence method (39.4%). The highest number of bio-film producers was isolated from urinary tract infections (36.61%). Conclusion: TCP method is most reliable, precise and sensitive method for detection of bio-film formation by Enterobacteriaceae isolates and is ideal to use as a general screening tool to detect bio-film production.

Keywords

Carbapenem resistant Enterobacteriaceae; bio-film; qualitative; quantitative assays.

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Nikita Jaiswal ¹, Varsha A. Singh ², Ali Ilham K. ³, Pankaj Saini ⁴, Gulnar ⁵

Affiliations
1 Assistant Professor, Department of Microbiology, MMIMSR, MMDU, Mullana, Ambala, Haryana, IN
2 Professor, Department of Microbiology, MMIMSR, MMDU, Mullana, Ambala, Haryana, IN
3 M.Sc. Student, Department of Microbiology, MMIMSR, MMDU, Mullana, Ambala, Haryana, IN
4 Junior Resident, Department of Microbiology, MMIMSR, MMDU, Mullana, Ambala, Haryana, IN
5 P.G. Tutor, Department of Microbiology, MMIMSR, MMDU, Mullana, Ambala, Haryana, IN

Abstract

Introduction: Tuberculosis is a major health problem faced by mankind since ancient times till date in spite of advances in our knowledge. Recently HIV hastened this & it became the single largest infectious diseasecausing high mortality in humans leading to numerous deaths annually. Early & prompt diagnosis is the only solution to control it. In developing country like India RNTCP depends on chest radiography & smear microscopy but culture is still GOLD standard method. Thus this study was designed to correlate the radiologically suspected tuberculosis cases with Zeihl-Neelsen staining & culture on LJ medium. Method: A cross-sectional study conducted on 60 radiologically suspected cases of pulmonary tuberculosis to compare the efficacy with conventional LJ medium culture and ZN staining. The samples were chosen using simple random sampling method. Results: Out of total 60 cases, 40(66.66%) cases showed positive results by any of the method. ZN staining (100%) rendered highest positivity than LJ media (80%) in far advanced with cavity while in minimal lesion LJ media (25%)was more effective than ZN staining (12.5%). Maximum number of Grading 3+ cases were with far advanced with cavity (100%) followed by moderate lesion with cavity (72.7%). Advanced with cavity showed highest and earliest growth i.e. 60% within 2 weeks while in moderate lesion with cavity it was 18.8% Conclusion: Correlation between radiological and microbiological findings must be the mainstay for the diagnosis in clinical suspected case of pulmonary TB.

Keywords

Tuberculosis, ZN staining, Cavity lesions, LJ media.

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Ritu Garg ¹, Rosy Bala ², Varsha A. Singh ³

Affiliations
1 Associate Professor, Maharishi Markandeshwar Institute of Medical Sciences & Research, MMDU, Mullana, Ambala (Haryana), IN
2 Assistant Professor, Maharishi Markandeshwar Institute of Medical Sciences & Research, MMDU, Mullana, Ambala (Haryana), IN
3 Professor & Head, Department of Microbiology, Maharishi Markandeshwar Institute of Medical Sciences & Research, MMDU, Mullana, Ambala (Haryana), IN

Abstract

Background: Active learning strategies for understanding the subject like microbiology is need of the hour. Small group teaching is considered to nurture active learning by the students. It is a student centered method and promotes active learning. So by keeping in mind the usefulness of the active learning, the present study was planned to assess the perception of students after introducing small group teaching (SGT) in Microbiology. Materials and Method: The study was conducted on 150 MBBS second year professional students in the department of microbiology of Maharishi Markandeshwar Institute of Medical Sciences & Research, Mullana. Small group teaching method were conducted for all selected topics. At the end of the sessions of SGT, perceptions of students were taken on feedback questionnaire and analysed on 3 point Likert scale. Result: Total 150 MBBS second Professional Students taken part in Study. Out of 150 students, 142 (94%) students took part in the study. Above 90% stated that it is easy and fun filled method, concepts are clearer and stronger, interaction increased with teachers, retention of the subject increased. Above 80% stated that willingness to study increased, doubts cleared easily, attention in the class increased, increased application of knowledge, sharing of ideas. Above 70% stated that clinical correlation, learn team work, self-directed learning. Conclusion: By Small group teaching, students will be apply their knowledge and will be able to provide effective diagnostic services in the community. Small group teaching can be easily adopted in curriculum by proper management of time and by cooperation of faculty and students.

Keywords

Small group teaching, active learning, student centred teaching method.

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