Browsing by Author "Dhawan, Benu"
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Item 0.5% Proparacain hydrochloride for clear corneal phacoemulsification in patients with co-morbid conditions.(2013-10) Kokkayil, Prathyusha; Rawre, Jyoti; Malhotra, Neena; Dhawan, BenuGenital tuberculosis is a common cause of female infertility in India. But, it is important to screen for other agents like Chlamydia trachomatis and genital Mycoplasmas as well to avoid persistence of infection and its long-term sequelae. Timely diagnosis of these infections using nucleic acid amplifi cation tests and institution of appropriate therapy will improve the conception rates in infertile women. We report a case of co-infection of Mycoplasma genitalium and Chlamydia trachomatis in an infertile female patient with genital tuberculosis. The infections were diagnosed using polymerase chain reaction, and the patient responded to a combination of antituberculosis therapy and 1 g single-dose Azithromycin.Item Antimicrobial susceptibility patterns of staphylococci in a tertiary care hospital.(2004-01-30) Dhawan, Benu; Mohanty, Srujana; Das, Bimal K; Kapil, ArtiItem Bacteriology of orthopaedic wound infections in an Indian Tertiary Care Hospital.(2005-06-23) Dhawan, Benu; Mohanty, Srujana; Das, B K; Kapil, ArtiItem Case report vancomycin -resistant Enterococcus faecium VanA phenotype: first documented isolation in India.(2006-03-28) Mohanty, Srujana; Dhawan, Benu; Gadepalli, R S; Lodha, Rakesh; Kapil, ArtiIn recent years, vancomycin-resistant enterococci, especially Enterococcus faecium has emerged as an important nososcomial pathogen and represents a serious threat to patients with impaired host defences. We report infection with vancomycin-resistant Enterococcus faecium in a 3-year-old child with patent ductus arteriosus. The organism, isolated from a central venous catheter tip, exhibited a high-level resistance to vancomycin (minimum inhibitory concentration > or = 256 microg/ ml) and was also resistant to teicoplanin. The child probably died due to sepsis from this highly resistant organism. To the best of our knowledge, this is the first reported isolation of VanA phenotype Enterococcus faecium in India.Item Changing pattern of Clostridium difficile associated diarrhoea in a tertiary care hospital: a 5 year retrospective study.(2008-04-26) Chaudhry, Rama; Joshy, Lovely; Kumar, Lalit; Dhawan, BenuBACKGROUND & OBJECTIVE: Frequent use of broad spectrum antibiotics in hospitalized patients has increased the incidence of Clostridium difficile diarrhoea in recent years. In our tertiary care hospital in north India, C. difficile was responsible for 15 per cent of cases of nosocomial diarrhoea in 1999. A retrospective study was carried out to determine the frequency of C. difficile associated diarrhoea (CdAD) in our hospital, and to assess the effect of awareness among the hospital personnel and control measures taken to present C. difficile infection following the previous report. METHODS: A retrospective chart review of all suspected cases of CdAD diagnosed at the hospital from January 2001 to December 2005 was done. Clinical specimens comprised 524 stool samples. All the samples were analyzed for C. difficile using culture and ELISA for toxin A and B. Attempts were made to type isolates using antibiogram, SDS-PAGE, gas liquid chromatography (GLC), PCR for toxin A and B gene fragments and restriction fragment length polymorphism (RFLP). RESULTS: A total of 37 (7.1%) specimens were positive for C. difficile toxin (11.2% in 2001, 9.4% in 2002, 8.6% in 2003, 5% in 2004 and 4% in 2005). The highest number of C. difficile toxin positive cases were from stool samples of patients hospitalized in the haematology/oncology ward (67.5% of all positive cases) followed by gastrointestinal surgery, neurology and nephrology wards. Of the C. difficile toxin positive samples, 15 (41%) were also positive for C. difficile culture. The isolates were grouped in to one, 3 and 5 groups using antibiogram, SDS-PAGE and PCR RFLP respectively. We observed an increase in the number of stool specimens tested for C. difficile infection but a decrease in C. difficile positives. INTERPRETATION & CONCLUSION: A decrease in the number of C. difficile positive cases were noted during the 5 year study period though number of samples tested was increased. This may be due to stringent surveillance and an improved antibiotic policy followed in the hospital.Item Chlamydia trachomatis serovar G infection in a bisexual male with urethritis.(2016-09) Rawre, Jyoti; Dhawan, Benu; Saigal, Karnika; Khanna, NeenaWe report a case of Chlamydia trachomatis serovar G urogenital tract infection in a 33-year-old human immunodefi ciency virus-1 (HIV-1) seropositive Indian bisexual male. This case highlights the emergence of a new serovar in India. The patient was tested positive for C. trachomatis by both cryptic plasmid and ompA gene polymerase chain reaction (PCR). On further characterization using polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) and ompA gene sequencing, the strain was found to be C. trachomatis serovar G. His spouse was also found to be infected with C. trachomatis serovar G. Phylogenetic analysis was performed on the clinical isolates obtained from both partners and were found to be identical to the isolates available in GenBank. The sexual network could not be traced further. Detection of a new genotype suggests importation of a new strain into the population probably by sexual contact with a person from a geographical area where the strain is common. Identifying circulating genotypes in the community can assist in developing strategies for improved sexually transmitted disease control.Item Clinical significance of airways colonization with Ureaplasma urealyticum in premature (<34 wk) neonates.(2007-05-24) Pandey, Anubhav; Dhawan, Benu; Gupta, Vikas; Chaudhry, Rama; Deorari, A KBACKGROUND & OBJECTIVE: Ureaplasma urealyticum has been implicated in various neonatal morbidities in preterm infants. Its association with chronic lung disease (CLD) remains controversial. The aim of this prospective study was to investigate colonization of U. urealyticum in preterm infants (with gestational age <34 wk) and to evaluate the relationship between U. urealyticum colonization and neonatal morbidity including CLD. METHODS: U. urealyticum was cultured from nasopharyngeal or endotracheal aspirates collected within 24 h of birth from infantItem Co-infections with Ureaplasma parvum, Mycoplasma hominis and Chlamydia trachomatis in a human immunodeficiency virus positive woman with vaginal discharge.(2013-04) Ghosh, Arnab; Rawre, Jyoti; Khanna, Neena; Dhawan, BenuA 30-year-old human immunodeficiency virus (HIV)-1 infected woman presented with vaginal discharge and associated vulval irritation. The vaginal swabs tested positive for Ureaplasma parvum and Mycoplasma hominis by both culture and polymerase chain reaction (PCR). The specimen also tested positive for Chlamydia trachomatis deoxyribonucleic acid (DNA) by cryptic plasmid and omp1 gene PCR assays. The patient was successfully treated with azithromycin based on the antibiotic susceptibility testing results of U. parvum and M. hominis by microbroth dilution. Since sexually transmitted infections enhance the transmission of HIV, HIV-positive patients should be screened routinely for these pathogens.Item Comparative in vitro activity of beta-lactam/beta-lactamase inhibitor combinations against gram negative bacteria.(2005-11-04) Mohanty, Srujana; Singhal, Ritu; Sood, Seema; Dhawan, Benu; Das, Bimal K; Kapil, ArtiBACKGROUND & OBJECTIVE: Currently, the use of beta-lactamase inhibitors in combination with beta-lactam antibiotics represents an effective measure to combat a specific resistance mechanism of beta-lactamase producing organisms. Knowledge about the susceptibility profile of bacteria to different combination agents available is essential to guide appropriate treatment of severe infections in hospitalized patients. The present study compares the in vitro activity of three commercially available beta-lactam/beta-lactamase inhibitor combinations (piperacillin/tazobactam, cefoperazone/sulbactam, ticarcillin/clavulanic acid) against beta-lactamase producing gram negative bacteria in a tertiary care hospital in north India. METHODS: A total of 9004 consecutively isolated extended spectrum beta-lactamase (ESBL) producing gram negative bacteria isolated from various clinical samples from patients admitted to the All India Institute of Medical Sciences, New Delhi, from September 2003 to August 2004 were included in the study. These isolates were screened for ESBL production by the inhibitor based test recommended by the National Committee for Clinical Laboratory Standards (NCCLS). Antibiotic susceptibility testing was carried out by disc diffusion method as per NCCLS guidelines. RESULTS: Of the 9004 isolates tested, 3232 (35.89%) were sensitive and 568 (6.31%) were resistant to all three combination agents, and rest 5204 (57.80%) were resistant to at least one of the combinations. Susceptibility to piperacillin/tazobactam, cefoperazone/sulbactam, and ticarcillin/clavulanic acid was 81.37, 76.06 and 45.48 per cent respectively. Piperacillin/tazobactam exhibited significantly (P<0.05) greater antimicrobial activity against Pseudomonas spp., Escherichia coli and Klebsiella spp. compared to cefoperazone/sulbactam. INTERPRETATION & CONCLUSION: Overall piperacillin/tazobactam was observed to be the best combination agent followed by cefoperazone/sulbactam in our setting. This difference in activities of these combination agents needs to be evaluated further by ascertaining their efficacy in clinical studies.Item Corynebacterium striatum: An emerging nosocomial skin and soft-tissue pathogen(All India Institute of Medical Sciences, 2021-04) Agrawal, Sonu Kumari; Khullar, Swati; Srivastava, Anurag; Kapil, Arti; Dhawan, BenuThe genus Corynebacterium is composed of Gram-positive, aerobic, non-motile, non-spore-forming bacilli that are widely distributed throughout the environment. They are usually found as commensals on the skin and are often considered as mere contaminants when isolated from clinical samples. We describe a patient with skin and soft-tissue infections due to Corynebacterium striatum following exploratory laparotomy identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. The clinical importance and pathogenic potential of Corynebacterium species, especially C. striatum, cannot be underestimated. This report is a reminder to physicians of the possible pathogenicity of non-diphtherial Corynebacteria.Item Diagnostic efficacy of a real time-PCR assay for Chlamydia trachomatis infection in infertile women in north India.(2014-08) Dhawan, Benu; Rawre, Jyoti; Ghosh, Arnab; Malhotra, Neena; Ahmed, Mir Muneer; Sreenivas, Vishnubhatla; Chaudhry, RamaBackground & objectives: Little is known about the prevalence of Chlamydia trachomatis infection in Indian women with infertility. To improve the diagnosis of C. trachomatis infection in developing countries, there is an urgent need to establish cost-effective molecular test with high sensitivity and specificity. This study was conducted to determine the diagnostic utility of a real time-PCR assay for detention of C. trachomatis infection in infertile women attending an infertility clinic in north India. tThe in house real time-PCR assay was also compared with a commercial real-time PCR based detection system. Methods: Endocervical swabs, collected from 200 infertile women were tested for C. trachomatis by three different PCR assays viz. in-house real time-PCR targeting the cryptic plasmid using published primers, along with omp1 gene and cryptic plasmid based conventional PCR assays. Specimens were also subjected to direct fluorescence assay (DFA) and enzyme immunoassay (EIA) Performance of in-house real time-PCR was compared with that of COBAS Taqman C. trachomatis Test, version 2.0 on all in-house real time-PCR positive sample and 30 consecutive negative samples. Results: C. trachomatis infection was found in 13.5 per cent (27/200) infertile women by in-house real time-PCR, 11.5 per cent (23/200) by cryptic plasmid and/or omp1 gene based conventional PCR, 9 per cent (18/200) by DFA and 6.5 per cent (7/200) by EIA. The in-house real time-PCR exhibited a sensitivity and specificity of 100 per cent, considering COBAS Taqman CT Test as the gold standard. The negative and positive predictive values of the in-house real time-PCR were 100 per cent. The in-house real time-PCR could detect as low as 10 copies of C. trachomatis DNA per reaction. Interpretation & conclusions: iIn-house real time-PCR targeting the cryptic plasmid of C. trachomatis exhibited an excellent sensitivity and specificity similar to that of COBAS Taqman CT Test, v2.0 for detection of C. trachomatis infection in women attending an infertility clinic. In an effort to prevent Chlamydia infection associated infertility, we recommend screening of women with infertility due to C. trachomatis infection by in-house molecular method as a cost-effective solution in resource limited settings.Item Emerging resistance to carbapenems in a tertiary care hospital in north India.(2006-07-24) Gupta, Ekta; Mohanty, Srujana; Sood, Seema; Dhawan, Benu; Das, Bimal K; Kapil, ArtiBACKGROUND AND OBJECTIVES: Carbapenems are beta-lactam antibiotics, presently considered as most potent agents for treating multi-drug resistant Gram-negative bacilli infections. In India carbapenems available for use are meropenem and imipenem, introduced recently. Resistance to these has been reported in a few bacteria especially Pseudomonas spp. We therefore retrospectively evaluated the antibiotic susceptibility pattern to these agents amongst various clinical isolates in a tertiary care hospital in north India. METHODS: In this study Gram-negative bacterial pathogens isolated from clinical samples were tested for extended spectrum beta lactamase (ESBL) production. All ESBL positive bacteria were tested for meropenem and imipenem activity pattern using NCCLS guidelines. A total of 2626 consecutively isolated Gram-negative bacteria, which tested positive for ESBL production by the double disk diffusion method, were included. RESULTS: The different bacteria isolated were Pseudomonas spp. 759, Acinetobacter spp. 676, Escherichia coli 569, Klebsiella spp. 343, Enterobacter spp. 150, Citrobacter spp. 57 and Proteus spp. 72. Overall resistance to meropenem was more (22.16%) than imipenem (17.32%). Maximum resistance was seen in Pseudomonas spp. M(R) 37.6 per cent, I(R) 30 per cent. In isolates from intensive care units (ICU) resistance to carbapenems was significantly higher than non-ICU patients. INTERPRETATION AND CONCLUSION: Resistance to meropenem and imipenem was seen in various clinical isolates of Gram-negative ESBL-positive bacteria. There is a need to alarm our clinicians for judicious use of antibiotics.Item Evaluation of different methods for detecting methicillin resistance in Staphylococcus aureus.(2006-07-15) Gadepalli, Ravi Sekhar; Dhawan, Benu; Mohanty, Srujana; Kapil, Arti; Das, Bimal K; Chaudhry, RamaItem Genital mycoplasma & Chlamydia trachomatis infections in treatment naïve HIV-1 infected adults.(2011-12) Ghosh, Arnab; Dhawan, Benu; Chaudhry, Rama; Vajpayee, Madhu; Sreenivas, VishnubhatlaBackground & objectives: Sexually transmitted infections (STIs) enhance the transmission of human immunodeficiency virus (HIV). Thus, screening for STIs is a routine component of primary HIV care. There are limited data for selective screening guidelines for genital mycoplasmas and Chlamydia trachomatis in HIV-infected adults. The aim of the present study was to determine the frequency of genital infections with Ureaplasma spp., Mycoplasma hominis, M. genitalium and C. trachomatis in treatment naïve asymptomatic HIV-1 - infected adults and study their association with CD4+ T-cell count. Methods: First-void urine samples were collected from 100 treatment-naïve HIV-1-infected adults and 50 healthy volunteers. C. trachomatis and M. genitalium were detected by polymerase chain reaction (PCR). Ureaplasma spp. and M. hominis were detected by both culture and PCR. Circulating CD4+ cell counts of HIV-1-infected patients were determined from peripheral blood by flow-cytometry. Results: C. trachomatis was detected in 7 per cent of HIV-1-infected adults compared to none in control population. Ureaplasma spp. and M. hominis showed infection rates of 6 and 1 per cent in the HIV group and 2 and 0 per cent in the control group, respectively. None of the individuals from the patient and control groups was tested positive for M. genitalium. A significant association was found between CD4 cell count and detection of C. trachomatis in HIV-infected adults (P = 0.01). Interpretation & conclusions: Screening of HIV-infected individuals for C. trachomatis infection could be recommended as a routine component of HIV care. The role of mycoplasmas as co-pathogens of the genitourinary tract in HIV-1 infected patients seems to be unlikely. Further longitudinal studies need to be done to confirm these findings.Item Genital Mycoplasma and Chlamydia trachomatis infections in patients with genital tract infections attending a tertiary care hospital of North India.(2016-04) Saigal, Karnika; Dhawan, Benu; Rawre, Jyoti; Khanna, Neena; Chaudhry, RamaLimited data are available on the prevalence of genital mycoplasmas and Chlamydia trachomatis (CT) among Indian patients with genital tract infections. The objectives of the study were to determine the prevalence of Ureaplasma urealyticum (UU), Mycoplasma hominis (MH), Mycoplasma genitalium (MG), and CT in patients with genital tract infections. The antimicrobial susceptibilities of UU and MH were also assessed. Endocervical swabs/urethral swabs and first void urine samples of patients (n = 164) were collected. UU and MH were detected by culture and multiplex polymerase chain reaction (PCR). MG and CT were identified by PCR. Ureaplasma isolates were further biotyped and serotyped. Antimicrobial susceptibility was done by microbroth dilution method. UU, MH, MG, and CT were detected in 15.2%, 5.4%, 1.2%, and 6% patients, respectively. Ureaplasma parvum serovar 3/14 was the most prevalent. All isolates of UU and MH were uniformly susceptible to doxycycline and josamycin. Routine screening for these pathogens and antimicrobial susceptibility testing is warranted to prevent sequel of infections and formulate treatment guidelines.Item Group C streptococcal bacteremia: a case report from India.(2004-12-27) Mohanty, Srujana; Kapil, Arti; Mohapatra, Manoranjan; Das, Bimal; Dhawan, Benu; Choudhry, V PGroup C streptococci are a common cause of infection in animals and a rare cause of bacteremia in human beings. The entity is often seen in elderly people with a severe underlying illness. We report here the only case of Group C streptococcal bacteremia reported in our hospital, caused by Streptococcus equisimilis, a beta-hemolytic Group C streptococcus. The patient was a 10-year old male with a known history of aplastic anemia. In spite of specific therapy with penicillin, the outcome was fatal.Item Inducible clindamycin resistance in clinical isolates of Staphylococcus aureus.(2006-04-20) Gadepalli, Ravisekhar; Dhawan, Benu; Mohanty, Srujana; Kapil, Arti; Das, Bimal K; Chaudhry, RamaItem Laboratory detection of bacterial pathogens and clinical and laboratory response of syndromic management in patients with cervical discharge: A retrospective study(Scientific Scholar, 2023-06) Yadav, Deepika; Singh, Sanjay; Dhawan, Benu; Sood, Seema; Gupta, SomeshBackground: Cervical discharge as part of cervicitis and pelvic inflammatory disease is a cause of significant morbidity in sexually active women worldwide. Non-gonococcal and non- chlamydial bacterial pathogens are becoming more prevalent. Aims: This study aims to determine bacterial pathogens causing cervical discharge using culture and/or polymerase chain reaction and assess the clinical and laboratory response to the conventional syndromic kit regimen established by the World Health Organisation. Methods: A retrospective review of records of women with cervical discharge over one year period. Culture and/or polymerase chain reaction results of endocervical swabs of various bacterial pathogens at baseline and after four weeks of treatment with syndromic kit regimen were recorded. Results: A total of 70 case records were reviewed for clinical details, out of which results of bacterial culture and polymerase chain reaction were available for 67 cases. Infectious aetiology was found in 30 (44.7%) patients with Ureaplasma species being the most common organism isolated on culture (18, 26.8%) and polymerase chain reaction (25, 37.3%), respectively. Polymerase chain reaction for Chlamydia trachomatis and Mycoplasma hominis was positive in ten (14.9%) and four (6%) cases, respectively. None of the patients showed positive culture for Neisseria gonorrhoeae. Coinfection was seen in eight (11.9%) patients with the majority showing Chlamydia trachomatis and Ureaplasma spp. coinfection (five patients). Forty one cases (58.5%) received tab. cefixime 400 mg and tab. azithromycin one gram stat (kit 1), while 29 cases (43.3%) received tab. cefixime 400 mg stat, tab. metronidazole 400 mg and cap. doxycycline 100 mg, both twice daily for 14 days (kit 6). Minimal to no clinical improvement with treatment was seen in 14 out of 32 cases (44%) at the end of four weeks with the conventional kit regimen. Post-treatment culture and/or polymerase chain reaction were positive in nine out of 28 cases (32.1%) with Ureaplasma spp. being the most common. Limitations: Retrospective study design, small sample size and fewer cases with follow-up data were the main limitations. Conclusion: Ureaplasma spp. was the most common infectious cause of cervical discharge in our patients. Treatment given as part of syndromic management led to a clinical and microbiological response in around half and two-third cases, respectively.Item Melioidosis; the remarkable imitator: recent perspectives.(2004-05-20) Loveleena,; Chaudhry, Rama; Dhawan, BenuMelioidosis is an important public health problem in some regions of the world. It is endemic in South East Asia. The clinical spectrum of melioidosis is extremely broad, and melioidosis requires awareness on the part of the clinician and the existence of a laboratory capable of isolating and identifying Burkholderia pseudomallei, the etiological agent of melioidosis. Beta-lactams such as ceftazidime is currently the treatment of choice. There is no vaccine licensed for human use. There is an urgent need for rapid diagnostic techniques and effective treatments that are affordable in countries where the disease is endemic.Item Meningitis due to Escherichia vulneris.(2005-03-05) Mohanty, Srujana; Chandra, Sharat P; Dhawan, Benu; Kapil, Arti; Das, Bimal K