Utpala Devi

Strongyloidiasis in Assam, India: A community-based study

Background: Strongyloidiasis is endemic in many tropical and subtropical countries and reports from northeast India are very few. Aim: A community-based study was carried out in Assam, India, to find out the occurrence of Strongyloides stercoralis. Materials and Methods: Stool samples were obtained from 198 randomly selected individuals from the community. Samples were processed using direct microscopy with formal-ether concentration methods. Results and Conclusion: Seventeen numbers of samples showed the presence of Strongyloides stercoralis (8.5%). A total of 105 (53%) individuals were positive for at least one intestinal parasite. The other intestinal parasites detected were Ascaris lumbricoides (33.3%), Trichuris trichiura (9.1%), hookworm (7.1%), Enterobius vermicularis (1.5%), and Giardia cyst (1.5%). Five out of 17 individuals positive for S.stercoralis had associated gastrointestinal, respiratory, and/or cutaneous symptoms.The present study although not exhaustive for true prevalence calls for attention in the backdrop of high malnutrition and pulmonary tuberculosis.

Sneathia species in a case of neonatal meningitis from Northeast India

Here we report the detection of Sneathia species most closely related to Sneathia sanguinegens, an infrequently reported bacterium, in the cerebrospinal fluid of a neonate by a culture independent method. Even though on rare occasions, this bacterium was isolated previously from the blood of neonatal bacteraemia cases. To the best of our knowledge there exists no previous report of detection of S. sanguinegens in the cerebrospinal fluid even though recently there has been a report of isolation of closely related species, Leptotrichia amnionii. The neonate recovered following antimicrobial therapy for 21 days. We conclude that uncultivable or difficult- to-cultivate bacteria like Sneathia could be an emerging pathogen for neonatal infection.

Vaginal Carriage of Antibiotic Resistant Escherichia coli by Pregnant Women: A Concern for the Neonate

Background: We report the resistance pattern and plasmid profile of vaginal isolates of Escherichia coli isolated from asymptomatic pregnant women attending the outpatient department of a primary health care centre in a district of North east India. Methodology: Antibiotic susceptibility was done by disc diffusion method and interpretation as sensitive, intermediate or resistant was done as per Clinical Laboratory Standards Institute’s interpretive standards for Enterobactereriaceae. E. coli ATCC 25922 was used as the control strain. Phenotypic screening for extendedspectrum beta-lactamase was done using the phenotypic disc confirmatory test. Plasmid DNA was extracted as per manufacturer’s instructions using commercially available kit. The plasmid band and size was estimated by comparison with a 1kb DNA marker. Results: A total number of 40 E. coli isolates were obtained after screening 246 pregnant women. Reduced susceptibility to at least one antimicrobial was seen in 34 isolates (85%) of E. coli. Highest resistance was to cefotaxime (60%). Twelve isolates (30%) were found to be multidrug resistant (reduced susceptibility to antimicrobial drugs belonging to ≥3 classes). Seventeen (42.5%) isolates were ESBL producers of whom 9 were multidrug resistant (MDR). Plasmid DNA isolation was done for thirty seven of the isolates of whom 4 did not show any band. The number of plasmids varied from 1 to 5 per isolate. Plasmid size ranged from 1 kb to above 10 kb when compared to a 1 kb ladder. Conclusion: This study demonstrates that drug resistant E. coli exists as colonizers in the genital tract of pregnant women.

Extended-spectrum β-lactamase & carbapenemase-producing Gram-negative bacilli in neonates from a tertiary care centre in Dibrugarh, Assam, India

The choice of first-line antibiotic for the initiation of treatment in cases of neonatal sepsis/meningitis is a challenge to a clinician. It is further complicated when it is suspected to be caused by drug-resistant bacteria. β-lactam antibiotics are used widely worldwide against infections caused by Gram-negative bacteria. Resistance is known to be due to various mechanisms among which production of extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs) is reported1-12.

Distribution of blood pressure & correlates of hypertension in school children aged 5-14 years from North east India

Background & objectives: Elevated blood pressure (BP) in the young predicts serious cardiovascular events in the adults. High prevalence of adult hypertension reported from Assam, North East (NE) India may be linked with elevated blood pressure in the childhood. The present study was an attempt to describe the distribution of BP and correlates of hypertension in children aged 5-14 yr. Methods: A total of 10,003 school children from 99 schools of Dibrugarh district, Assam, NE India, were surveyed by stratified random cluster method. Blood pressure, demographic and anthropometric information were recorded. Blood pressure was categorized in to normal, prehypertension, stage I and stage II hypertension. Results: Girls had significantly higher (104.2 ± 12.0 vs. 103.2 ± 11.6 mm Hg, P<0.001) mean systolic blood pressure (SBP) than boys. Both SBP and diastolic blood pressure (DBP) revealed significant correlation with age, height, weight and BMI in overall and in gender specific analysis. Hypertension was found in 7.6 per cent school children (Boys: 7.3%, Girls: 7.8%). In multivariable analysis older age (OR 3.3, 95% CI: 2.82-3.91), children from tea garden community (OR 1.3, 95% CI: 1.08-1.55) and other community (OR 1.4, 95% CI: 1.18-1.73) and overweight (OR 1.5, 95% CI: 1.1-2.1) were independently associated with hypertension. Interpretation & conclusions: Mean blood pressure in the young school children of 5-14 yr was high. A programme comprising screening, early detection and health promotion through school health programmes may help prevent future complications of hypertension.