Supriya Meshram

Abstract

Background: A Gram-positive spore forming bacilli, aerobe or facultative anaerobe is Bacillus cereus. It is ubiquitous which disperse in the environment. Bacillus is a potential pathogen accountable for fulminant human infectious disease and hardly ever contribute to eye infections.  Case Presentation: A 35-year-old farmer came to ophthalmology OPD on February 2019, and the patient complained of acute onset left eye pain with diminution of vision. There was history of eye injury by the vegetation (thorn). There was presence of corneal ulcer. The patient was not immunocompromised. Corneal scrapping was collected from left eye. On Gram staining from corneal scrapping only two Gram positive bacilli, with occasional pus cell and fibrinous exudate was seen. Culture on blood agar medium it showed beta haemolytic, about 2-5 mm in diameter, big flat, irregular edges and greyish white colonies which were oval, slightly granular but not dry. On Mac -Conkey agar medium it showed non lactose fermenting, big flat, irregular colonies. From colonies Gram staining showed Gram positive bacilli with spore. They were motile, catalase positive, oxidase positive, reduced nitrate to nitrite and were resistant to penicillin. The identification was also confirmed by Vitek. Conclusion: This case highlights the importance of cultivation, detection and antibiotic susceptibility test rather than treating patients with ocular infection empirically. Keywords: Corneal ulcer, Bacillus species, Bcereus

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Abstract

Level of drug resistance among new TB patients indicates the efficacy of any control programme. A drug resistance survey, as a part of global study in new pulmonary tuberculosis (NPTB) patients, was conducted in Wardha district, India under WHO /IUTLD in 2001, before the implementation of the Revised National Tuberculosis Control Programme (RNTCP) which was implemented in the district in 2002. Objective: The present study was conducted in Wardha district in 2014-2015, thirteen years after the implementation of RNTCP, and the drug resistance in Mycobacterium tuberculosis isolates from NPTB patients was compared to the results of 2001 survey. The methodology used was same in both the surveys.  Material and Methods: In addition to 132 isolates fromWardha, the study also included 112 isolates from adjoining city, Nagpur and total of 244 sputum isolates were subjected to drug sensitivity by standard 1% proportion method on Lowenstein Jensen’s medium. In addition molecular typing of resistant strains was done. Results: In Wardha, compared to 2001 survey, overall susceptibility to first line drugs was higher (94.7% vs 80.2%); and resistance to streptomycin (3% vs 7.6%) and isoniazid (2.2% vs 15.2%) were significantly lower (p 0.05). MDR was 0.75% against 0.50% in the earlier study but the difference was statistically not significant. Only two MDR isolate were recovered, of which only one was from Wardha.  Conclusion: After the implementation of RNTCP in Wardha District, drug resistance in new PTB patients has shown a decline and MDR continues to be low reflecting upon the efficiency of the program. Keywords: Resurvey, New Pulmonary TB patients, Drug Resistance

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