Jaswinder Singh Gill

Abstract

Introduction: The clinical importance of the genus Enterococcus species relates to its intrinsic antibiotic resistance. Synergistic activity of penicillin and aminoglycosides against Enterococcusis preferred treatment. However, Infectious Diseases Society of America (IDSA) recommends usage of linezolid and daptomycin against emerging vancomycin resistant Enterococcus(VRE) isolates. In this study, we sought to measure the prevalence of vancomycin, linezolid and daptomycin resistance in Enterococcus clinical isolates from patients in a tertiary hospital of Western Maharashtra. Materials and Methods: A total of 363 clinical isolates of Enterococcusspecies isolated from different clinical samples over the last three years and three months study period were analyzed for antibiotic susceptibility pattern against vancomycin, linezolid and daptomycin. Results: Study demonstrated low prevalence of vancomycin (4.95%) and linezolid resistance (1.10%) among Enterococcus clinical isolates. Combined resistance to vancomycin and linezolid was also noted in few isolates. No daptomycin resistance was detected in this study, however in vitro daptomycin susceptible and vancomycin heteroresistance isolates may not respond to daptomycin monotherapy. Conclusion: Our study, demonstrated relatively low prevalence of vancomycin and linezolid resistance, but emergence of combined newer drug resistance in Enterococcus species is cause of concern and reiterates the importance of importance of judicious use of antibiotics. Keywords: VRE, Linezolid, Daptomycin, E test.

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Introduction: Dermatophytes fungi infect keratinized tissues such as hair, nails and skin. Different methods for sample collection and transportation of dermatophytes for culture have been described. The standard methods for dermatophytes sample collection, transportation and lab processing, results in low positive culture dermatophyte yield. In this study, we have compared the standard method (Protocol A) with modified sample processing protocol (Protocol B), developed by our department. This modification was based on the core concept of collection, inoculation, starting incubation and transportation of dermatophyte sample, at patient’s point of care. Materials and Methods: A total of 200 clinical isolates of dermatophytes, were subjected to two different sample processing protocols. Standard method was Protocol A and laboratory developed method was labelled as Protocol B. Protocol B, included a small (7ml) transparent plastic tube with special culture media. These tubes were inoculated with sample at patient’s point of care and same tube were utilized as transportation media. Results: Samples processed as per modified protocol (Protocol B), demonstrated positive dermatophyte culture yield in 160 out of 200 samples, whereas figures were 80 out of 200 for samples processed as per standard protocol (Protocol A). Difference in positive dermatophyte culture yields, were statistically significant. The contamination rates of dermatophyte culture by saprophytic fungus and bacteria, was measured, 6% for Protocol A and 1% for Protocol B. Conclusion: Our study demonstrated that a simple, economical modification in the procedure for dermatophyte sample processing by the laboratory, has led to a significant increase the positive dermatophyte culture yield with reduced secondary contamination rates. Keywords: Dermatophytes, Sabouraud dextrose agar, Fungal culture, Contamination.

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Introduction: In era of organ transplants and immunocompromised patients, systemic mycosis has emerged as a major cause of morbidity and mortality among these patients. Research on these clinical fungal isolates is the key to the development of antifungal diagnostics and therapeutic agents. Mycology laboratories has to preserve these pathogenic fungal strains for various experiments. These laboratories requires a preservation method that ensures purity, viability, stability and biochemical characteristics of the fungal isolates during the storage period. Objectives: To determining the purity, viability, stability and biochemical characteristics of clinical fungal isolates subjected to three different, but simple and inexpensive preservation methods. Materials and Methods: A total of 50 clinical isolates of yeast and mold were subjected to different preservation Methods: All the isolates were evaluated for purity, viability, stability and biochemical characteristics before storage and after 6 months and one year. Stability testing was based on antifungal susceptibility testing as recommended by CLSI. Results: All the three preservation methods, ensured survival of all the fungal strains for one year duration. Periodic subculture method on agar slope demonstrated mild colony morphological changes in 2 molds and high contamination rate. Water culture technique and oil overlay technique, demonstrated protection of purity, viability, stability and biochemical characteristics of all the fungal isolates up to one year of storage. Conclusion: Comparison of different fungal storage methods suggested that both water technique and oil overlay technique can be utilized as a simple, effective and inexpensive methods for long term preservation of clinical fungal isolates. Keywords: Preservation, Storage, Yeast, Molds, CLSI.

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