Hiren Patel

Abstract

Corona virus (SARs CoV-2) has caused immense effect on morbidity and mortality of the population globally. We undertook this study as we are a part of one of the network laboratories of ICMR to test the patient’s sample by RT PCR for the ORF 1 ab gene of corona virus. Materials and Methods : For a period of one and half months (14 April to 31 May 2020) we tested the nasopharynx and oro-pharynx swab samples sent to us in VTM from the assigned districts of Gujarat. All the samples were subjected to RT PCR method by following standard methods. Results: Total of 9.04%(256/2833) population was positive and 4.73%(139/2833) belonged to age groups 21-40 and 2.33% (66/2833) to 41-60yrs. Above the age of 60yrs there were only 0.95% (22/2833) cases which were positive. It was advantageous to pool the samples. Out of the number of pools prepared, we reported around 80% negative and rest were positive in pools. The study also included association of viral load and infectivity. We found that 12% of the asymptomatic people and 5.1% of symptomatic individuals had high viral load. Conclusion : It is seen that the incidence of Novel corona virus -19 detection by RT PCR is a reliable method and the establishment of the Ct value and infectivity of the patient to the health care workers and relatives needs to be taken care of. Also, the study presents asymptomatic patients having high viral loads being highly infective.   Keywords: Corona virus, SARs coV­2, ORF 1ab gene, COVID­19, Ct Value

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Abstract

Candida spp. and Cryptococcus spp. are important fungal pathogens in cancer patients. Non- albicans Candida are of special concern, since some are highly virulent and show reduced susceptibility to antifungal agents. Non- neoformans Cryptococcal infections have also shown an incremental rise over the past four decades. The aim of this retrospective study was to evaluate the prevalence, distribution and susceptibility pattern of various species of Candida and Cryptococcus causing infections in cancer patients. This Retrospective study was conducted from Jan 2011 to Aug 2016. Yeasts/ yeast like fungi isolated in various specimens received for fungal and also bacterial culture were included. Fully automated VITEK 2 compact was used for final species identification and susceptibility testing of isolated yeasts. The prevalence of infections was 1.36% during the study period with prevalence being 0.54% in patients with haematological cancer and 2.45 in patients with Solid tumours. Among various solid tumours maximum infection rate was seen in patients with head and neck cancers i.e. 4.01%. A total of 9.09% growths were responsible for Blood Stream Infections (BSI). Most common Candida sp. isolated was C.tropicalis (37.06%) followed by C.albicans (36.87%). Out of total 35 Cryptococcus sp. isolated 30 were Cryptococcus laurentii and only 5 were Cryptococcus neoformans. Low level of resistance was shown by C.albicans to all the antifungal agents. C.tropicalis also showed low resistance with only 2.01% resistance to Fluconazole and Amphotericin B. Higher resistance rate was observed in C.krusei with 7.69% isolates resistant to Fluconazole and 15.38% resistant to Amphotericin B. Rate of resistance shown by C.glabrata to Fluconzole was also quite high i.e. 9.09%. Most of the Candida sp. showed good sensitivity to both Caspofungin and Micafungin except C.krusei with 15.38% resistance to both candins. Out of all the antifungal agents tested for Voriconazole was the most effective for all the yeasts isolated with highest resistance rate being 7.69% shown by C. krusei. All Cryptococcus neoformans isolated were sensitive to the antifungal agents tested for. i.e. Amphotericin B, Flucytosine, Fluconazole and Voriconazole. Our study emphasizes the need to make new prophylaxis policies for Candida infections. Also further studies should be conducted to determine the antifungal susceptibility pattern of Cryptococcus laurentii. Keywords: Antifungal, Cryptococcus, Candida, Cancer, Yeast.

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