Browsing by Author "Ayyagari, A"
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Item Acute diarrhea in infants and children: a bacteriological study.(1981-06-01) Agarwal, K C; Panhotra, B R; Walia, B N; Ayyagari, A; Joshi, PItem Alpha and non-haemolytic streptococcal bacteraemia.(1981-02-01) Panigrahi, D; Agarwal, K C; Usha, R; Garg, R K; Ayyagari, AItem Antibiotic associated colitis in children.(1985-12-01) Venkateswarlu, K; Ayyagari, A; Sharma, P; Malik, A K; Mehta, SItem Antibiotic associated diarrhoea: Infectious causes.(2003-01-24) Ayyagari, A; Agarwal, J; Garg, ANearly 25% of antibiotic associated diarrhoeas (AAD) is caused by Clostridium difficile, making it the commonest identified and treatable pathogen. Other pathogens implicated infrequently include Clostridium perfringens, Staphylococcus aureus, Klebsiella oxytoca, Candida spp. and Salmonella spp. Most mild cases of AAD are due to non-infectious causes which include reduced break down of primary bile acids and decrease metabolism of carbohydrates, allergic or toxic effects of antibiotic on intestinal mucosa and pharmacological effect on gut motility. The antibiotics most frequently associated with C. difficile associated diarrhoea are clindamycin, cephalosporin, ampicillin and amoxicillin. Clinical presentation may vary from mild diarrhoea to severe colitis and pseudomembranous colitis associated with high morbidity and mortality. The most sensitive and specific diagnostic test for C. difficile infection is tissue culture assay for cytotoxicity of toxin B. Commercial ELISA kits are available. Though less sensitive, they are easy to perform and are rapid. Withdrawal of precipitating antibiotic is all that is needed for control of mild to moderate cases. For severe cases of AAD, oral metronidazole is the first line of treatment, and oral vancomycin is the second choice. Probiotics have been used for recurrent cases.Item Antimicrobial susceptibility pattern & biotyping of Helicobacter pylori isolates from patients with peptic ulcer diseases.(1995-12-01) Sharma, S; Prasad, K N; Chamoli, D; Ayyagari, AAntimicrobial susceptibility of 50 local isolates of Helicobacter pylori from patients with acid peptic diseases was investigated to commonly used antibiotics. The maximum resistance was (66%) detected to metronidazole (MIC > 8 micrograms/ml). The frequency of resistance to ampicillin, erythromycin, ciprofloxacin was in the range of 20-28 per cent; least resistance was observed to tetracycline (10%). The gradient disc diffusion method was found to give reproducible results and also correlated with agar dilution method for minimum inhibitory concentration (MIC). Study of the enzymatic activity of H. pylori isolates showed that all isolates had urease, catalase, oxidase, esterase-lipase, and naphthol-AS-beta-1-phosphohydrolase enzymes and were consistently negative for ten other enzymes tested. Majority of the isolates expressed alkaline phosphatase (17/18), esterase (17/18) and acid phosphatase (14/18). The acid phosphatase had the maximum mean enzymatic activity. There was no difference in enzymatic activity between H. pylori isolates from ulcer and gastritis patients. H. pylori isolates could be typed into five biotypes. Type III was found to be more common (44.4%). This study supports the existence of the strain variations among H. pylori on the basis of the enzyme profiles.Item Antiribitol-teichoic acid antibody (ARTA) in diagnosis of deep seated Staphylococcus aureus infections.(1991-07-01) Ayyagari, A; Pal, NAntiribitol-teichoic acid antibody (ARTA) was detected in sera of 30 out of 50 patients (60%) with various acute deep seated Staphylococcus aureus infections and 5 out of 10 chronic osteomyelitis cases, whereas none of the sera from 50 patients with superficial Staphylococcus aureus infections as well from 50 patients without Staphylococcus aureus infections showed antibody response (p less than 0.01). This test is a definite advantage in diagnosis of deep seated staphylococcal infections like endocarditis, lung disease, meningitis and specially in osteomyelitis cases where organisms cannot be isolated and therefore helps in predicting the need for long term antimicrobial therapy.Item Arcanobacterium haemolyticum brain abscess in a child (a case report).(1991-04-01) Chhang, W H; Ayyagari, A; Sharma, B S; Kak, V KItem Bacterial isolates from mechanically ventilated patients with nosocomial pneumonia within intensive care unit of a tertiary care center.(2005-12-07) Nag, V L; Ayyagari, A; Venkatesh, V; Dash, N R; Ghar, M; Prasad, K NNosocomial pneumonia is a common complication in mechanically ventilated patients. A study was carried out to determine the incidence, common bacterial etiologic agents and their antimicrobial susceptibility, and outcome of such pneumonia in an Intensive Care Unit (ICU) of a tertiary care center. In Surgical ICU (SICU) 176 patients required mechanical ventilation for more than 72 hours. A total of 39 (22.1%) of these patients developed nosocomial bacterial pneumonia as determined by microbiological assays. Endotracheal aspirate cultures detected a single bacterial isolate in 22 (56.4%) patients while two and three organisms were isolated from 10 (25.6%) and 7 (17.9%) patients respectively. Fifty three (84.1%) of a total of 63 isolates were Gram negative bacilli. The most frequently encountered pathogens were Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter species among the Gram negative bacilli and Staphylococcus aureus among the Gram positives. Resistance of bacterial isolates varied from 24 to 90% against commonly used antibiotics. Amikacin had the best profile, with 14% to 55% resistance against various isolates. Twenty three (59%) of 39 patients with pneumonia expired in the ICU. P. aeruginosa (25.6%) and K. pneunmoniae (17.9%) were the predominant isolates in these patients. Nosocomial pneumonia with high mortality is a frequent occurrence in mechanically ventilated patients in our ICU setting. Gram negative organisms with high levels of antimicrobial resistance are the most common isolates. Regular surveillance and monitoring of changes in antibiotic susceptibility of bacterial pathogens and appropriate therapeutic measures are likely to reduce the mortality in these patients.Item Bacteriological spectrum of brain abscess with special reference to anaerobic bacteria.(1983-02-01) Ayyagari, A; Pancholi, V K; Kak, V K; Kumar, N; Khosla, V K; Agarwal, K C; Gulati, D RItem Biliary bacterial flora in surgical patients with biliary tract disease.(1988-04-01) Babu, J S; Bose, S M; Wig, J D; Ayyagari, AItem Campylobacter species associated with diarrhoea in patients from a tertiary care centre of north India.(2001-07-05) Prasad, K N; Dixit, A K; Ayyagari, ABACKGROUND & OBJECTIVES: Most laboratories do not routinely distinguish the various Campylobacter species, though almost all Campylobacter species have been isolated from human faeces. The epidemiological and clinical aspects of its infection and the species involved in genesis of diarrhoea are least understood in the developing countries. The aim of the present study was to find out frequency of Campylobacter species isolated from patients with diarrhoea over a 12-year period and to analyse their features. METHODS: Campylobacter strains isolated from stool samples of patients with diarrhoea were identified to the species level on appropriate media at 42 degrees C micro-aerobically. Patients' demography and clinical data were analyzed retrospectively; 25 Campylobacter jejuni strains were tested for toxin production and 23 strains were typed by Penner scheme. RESULTS: A total of 62 strains were isolated from 59 patients and the various species were C. jejuni 51 (82.3%), C. coli 8 (12.9%), C. lari 2 (3.2%), and C. upsaliensis 1 (1.6%). Children < 5 yr of age were most affected (34/59; 57.6%), followed by patients in 15-30 yr of age (12/59; 20.3%). Presentation of watery diarrhoea was significantly more common than inflammatory diarrhoea (50/59, 84.7% vs 9/59, 15.3%; P < 0.001). Recurrence occurred in 3 (5.1%) patients. Majority of the infections resolved within one week; one HIV-positive patient had chronic diarrhoea. Two patients developed Guillain-Barré syndrome following Campylobacter infection. Twenty (80%) of 25 strains were toxigenic and 20 (87%) of 23 strains could be typed by Penner scheme. INTERPRETATION & CONCLUSION: In our patients, 4 different Campylobacter species and various C. jejuni serotypes were involved in gastroenteritis. Majority of the infections were watery diarrhoea and in children < 5 yr of age. There is a need of a population-based systematic study to know the epidemiology of whole spectrum of campylobacters in India.Item Candidaemia in patients of a tertiary health care hospital from north India.(2003-03-25) Verma, A K; Prasad, K N; Singh, Manisha; Dixit, A K; Ayyagari, ABACKGROUND & OBJECTIVES: Candidaemia is an important cause of mortality in hospital settings. Limited information is available from India on nosocomial candidaemia. The objective of the present study was to isolate and identify yeasts from patients suspected to have nosocomial bloodstream infection (BSI) and to determine the carriage rate of Candida species, risk factors for acquisition of infection and mortality in this group of patients. METHODS: Blood samples from 4871 patients suspected to have BSI at least 48 h after admission were cultured following standard protocol to isolate and identify the pathogens. Clinical details, possible risk factors and outcome of all candidaemic patients were recorded and analysed. Samples of hand washings and throat gargles from these patients were also cultured to determine the carriage rate. Candida albicans isolated from patients and their carriage sites were genotyped by randomly amplified polymorphic DNA (RAPD) analysis to study strain relatedness. RESULTS: Twenty one patients with candidaemia were detected with mortality of 55 per cent. Candidaemia per 1000 admissions was 1.61. Isolation of non-C. albicans Candida species was significantly higher than C. albicans (14/21 vs 7/21: P < 0.05). Use of broad-spectrum antibiotics (43%), gastrointestinal surgery (23%), immunosuppressive therapy (23%), protein calorie malnutrition with parenteral hyperalimentation (23%) and neutropaenia (14%) were identified as probable risk factors. The seven C. albicans strains isolated from patients with BSI were typed into 6 genotypes. Yeast carriage rate among the patients was 71.4 per cent. C. albicans isolated from the hand, throat and blood of two patients had identical genotype. INTERPRETATION & CONCLUSION: BSI due to non-C. albicans Candida species is more common than C. albicans in our patients and candidaemia is associated with high mortality. RAPD appears to be a simple method to study strain relatedness for C. albicans. There is a need for early diagnosis and systematic surveillance to meet the challenges of nosocomial candidaemia.Item A comparative study of bacteriologically proved and clinically diagnosed (culture negative) cases of diphtheria.(1976-12-01) Dutta, J K; Ayyagari, A; Gautum, A P; Chadha, S K; Ray, S NItem Comparison of various conventional methods with a polymerase chain reaction assay for detecting methicillin-resistant & susceptible Staphylococcus aureus strains.(2000-12-15) Prasad, K N; Kumar, R; Tiwari, D P; Mishra, K K; Ayyagari, ABACKGROUND & OBJECTIVES: Methicillin-resistant Staphylococcus aureus (MRSA), a major nosocomial pathogen world-wide, is often difficult to detect due to the heterogeneous nature of expression of oxacillin resistance. In the present study, various conventional methods were compared with polymerase chain reaction on 106 clinical isolates of Staph. aureus for detection of oxacillin resistance. METHODS: A total of 106 clinical isolates of Staph. aureus were tested for oxacillin resistance by disc diffusion, screen agar plates (3 micrograms and 6 micrograms/ml of oxacillin), oxacillin broth (3 micrograms/ml) and mecA based PCR. RESULTS: PCR detected mecA gene amplified product of 604 bp in 57 strains. Disc diffusion failed to detect 7 mecA positive strains but identified 5 mecA negative strains as oxacillin resistant. Screen agar 3 micrograms, screen agar 6 micrograms and oxacillin broth 3 micrograms detected 55, 53 and 55 respectively of the 57 mecA positive strains; however, they also falsely identified 5, 3 and 3 strains of mecA negative strains respectively as oxacillin resistant. The sensitivity, specificity and accuracy of disc diffusion, 3 micrograms screen agar, 6 micrograms screen agar and 3 micrograms oxacillin broth against PCR as gold standard were as follows: 87.7, 89.9 and 88.7 per cent; 96.5, 89.8 and 93.4 per cent; 93.0, 93.9 and 93.4 per cent; 96.5, 93.9 and 95.3 per cent respectively. INTERPRETATION & CONCLUSIONS: The present study demonstrated that disc diffusion test was least reliable and 3 micrograms broth had the highest sensitivity and specificity when compared with PCR for detection of oxacillin resistance. Because of variations among the methods, a combination of tests should be used for the accurate detection of MRSA till new guidelines by an appropriate body are formulated.Item Counter current immunoelectrophoresis in the diagnosis of Haemophilus influenzae meningitis in children.(1979-08-01) Ayyagari, A; Kumar, L; Agarwal, K C; Sharma, M; Pande, DItem Counter current immunoelectrophoresis in the rapid diagnosis of pneumococcal meningitis.(1980-11-01) Ayyagari, A; Kumar, L; Sharma, M; Chitlangya, S N; Agarwal, K CItem Cryptococcal infection in patients with clinically diagnosed meningitis in a tertiary care center.(2003-09-04) Prasad, K N; Agarwal, J; Nag, V L; Verma, A K; Dixit, A K; Ayyagari, AA retrospective analysis of 326 clinically diagnosed cases with meningitis over a period of five-and-a-half years was carried out to determine the prevalence of cryptococcal infection, its associated risk factors and therapeutic outcome. Fifty-four (16.6%) patients with cryptococcal meningitis were identified by smear examination, culture and/or cryptococcal antigen latex agglutination test. Records of 45 cryptococcal meningitis patients were available; 18 (40%) of them were apparently healthy immunocompetent individuals, 13 (28.9%) had human immunodeficiency virus (HIV) infection, 9 (20%) were renal transplant recipients, 4 (8.9%) were diabetic and 1 (2.2%) had systemic lupus erythematosus. Ten (22.2%) patients died and 11 (24.4%) patients (all HIV-positive) left against medical advice. The present study indicates that cryptococcal infection is associated with high mortality. Presenting symptoms being indistinguishable from other causes of central nervous system infection, all patients with a clinical diagnosis of meningitis, irrespective of their immune status should be investigated for cryptococcal infection.Item The current status of pyogenic meningitis in children.(1980-05-01) Kumar, L; Chitlangiya, S; Ayyagari, AItem Detection of H. pylori infection.(1995-09-01) Ayyagari, A; Sharma, SItem Discontinuous counter current immunoelectrophoresis in Haemophilus meningitis (a case report).(1977-11-01) Ayyagari, A; Iyer, R V; Agarwal, K C; Kumar, L