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Biomedical subjects

A Kapil

Publications and source records attributed to A Kapil.

At least 37 records · Page 2Linked to original sources
PubMed2001

Uropathogenic Escherichia coli causing urinary tract infections.

BACKGROUND & OBJECTIVES: The information on the characteristics of Escherichia coli causing urinary tract infections is limited. We have characterised the urovirulence factors of Esch. coli isolated from symptomatic patients of urinary tract infections (UTI) in order to determine their pathogenic potential and the antibiotic sensitivity profile. METHODS: Semi-quantitative urine culture was done on 370 symptomatic patients suffering from urinary tract infections. Phenotypic characterization of the urovirulence factors of Esch. coli was undertaken and the antibiotic susceptibility was determined. RESULTS: Esch. coli was responsible for 45.5 per cent of infections. Resistance to amoxycillin, cotrimoxazole, nalidixic acid, norfloxacin and ciprofloxacin among Esch. coli isolates ranged from 70-95 per cent. Serotype O101 was found to be the commonest serotype (7/26). The virulence factors associated with uropathogenic Esch. coli were haemolysin production (5/30), presence of mannose resistant P-fimbriae (5/30), presence of mannose sensitive type 1 fimbriae (6/30) and the presence of mannose resistant F-fimbriae (2/30). Siderophores production was seen in all the isolates causing UTI. INTERPRETATION & CONCLUSION: Esch. coli was found to be the commonest cause of UTI in our study population. Antibiotic resistance was high among the strains circulating which emphasises the need for judicious use of antibiotics. Certain virulence factors like haemolysin production and presence of fimbriae in the Esch. coli may be associated with the urovirulence.

Anti-Bacterial Agents↗
PubMed2001

Group B streptococcal bacteremia in an adult: a case report from India.

The incidence of group B streptococcal bacteremia in adults has increased in recent years, particularly in patients with severe underlying diseases. However, group B still remains an unusual pathogen in adults in developing countries. We report a case of group B streptococcal bacteremia in a non-pregnant adult, the only case reported in our hospital. The organism was only isolated from the blood and responded to specific therapy.

Adult↗
PubMed2000

Diphtheria in urban slums in north India.

We recorded a reappearance of cases of microbiologically confirmed diphtheria in a tertiary care hospital in north India. Poor immunisation coverage, population migrations, and overcrowded urban slums may be contributory factors.

Child↗
PubMed2000

Infections in acute leukemia: an analysis of 240 febrile episodes.

Infections are the major cause of morbidity and mortality in acute leukemia patients. Case records of 91 consecutive patients (AML-48, ALL-40, RAEB-t/AML-3) treated between January 1997 and July 1999 were studied to determine the type, frequency and severity of infections. Patients' median age was 36 y (range 6-66) and male to female ratio was 2.5:1. A total of 240 febrile episodes were recorded; of them, 162 were associated with neutropenia (absolute neutrophil count, ANC<500/mm3) and 78 were without neutropenia. Among the neutropenic episodes, an infectious etiology could be documented in 52%; the remainder (48%) were defined as isolated febrile episodes. Chest was the most common site of infection (35. 7%) followed by skin, soft tissue (13%), GIT (7%) and genitourinary tract (6%) infections in order of decreasing frequency. Microbiologically, gram positive organisms (staphylococcus aureus, coagulase negative staphylococcus, streptococcus, enterococcus) were the most common isolates (52.8%) followed by gram negative organisms (E. coli, klebsiella, pseudomonas) in 42.8% of isolates. Two patients had pulmonary tuberculosis and three patients had fungal infections (candida-2, aspergillus-1). Among non-neutropenic patients, infection could be documented in 36%; the remaining 64% were isolated febrile episodes. Gram negative infections were documented in 50%, gram positive in 30% and fungal infections (candida-4, aspergillus-1, mucormycosis-1) in 20% of them. A combination of third generation cephalosporin and an aminoglycoside were used in 79% of episodes initially; a combination of a newer penicillin and aminoglycoside (4.6%), double betalactums (4.1%), oral antibiotics (9.8%) and others were used in the remaining episodes. Fever resolved in 38% of episodes using the above combinations; in the remainder second line antibiotics (mainly vancomycin) and antifungals (amphotericin-B) were added empirically or depending on culture and sensitivity. In 52.5% of episodes fever resolved after addition of second line antibiotics and antifungals. 11 of 91 patients died of infectious complications in this study. There is a need for improvised diagnostic tests to detect infections early as well as for new therapies to overcome antimicrobial resistance.

Adolescent↗
PubMed1999

Biotyping of Acinetobacter species isolated from clinical samples.

We used the biotyping scheme using carbohydrate substrate utilization test with 14 carbon sources to speciate Acinetobacter isolates from blood and cerebrospinal fluid cultures of patients admitted to the postoperative neurosurgery ICU during January to November 1996. Sixty one patients culture positive for Acinetobacter sp. from blood or cerebrospinal fluid were followed up prospectively. Among these patients, 40 patients had clinically diagnosed infections like bacteriemia or meningitis while in 21 patients the isolation was regarded as contaminants. A. baumanniii was the most common isolate associated with clinical infections while A. lwoffii was more likely to be an environmental contaminant.

Acinetobacter↗
PubMed1999

An indigenously developed nitrite kit to aid in the diagnosis of urinary tract infection.

OBJECTIVE: To evaluate the utility of an indigenously developed nitrite kit for the rapid diagnosis of urinary tract infection (UTI) METHODS: 1018 urine specimens were collected from all cases where there was clinical suspicion of UTI. Samples were cultured as per standard microbiological protocol. Presence of nitrites was indicated by the development of purple color on addition of color developing solution and compared with the set of graded positive and negative controls also provided in the Kit. RESULTS: The results of the nitrite kit were compared with the semi-quantitative urine culture as the gold standard. The sensitivity, specificity, positive predictive and negative predictive values were 47%, 87%, 31% and 93%, respectively. CONCLUSION: Nitrite kit as a screening test can decrease the work load in the clinical bacteriology laboratory. More importantly in a field set up that is devoid of culture facilities, it can be used to correctly predict the absence of UTI.

Adult↗
PubMed1999

Screening of sputum: an experience in a tertiary care hospital.

In order to reduce the work load on the clinical laboratory, it has been recommended that sputum samples, before accepting for culture, should be looked for the presence of polymorphs and squamous epithelial cells. (An appropriate sample should have more than 25 polymorphs per low power field and less than 10 epithelial cells per low power field; others are labelled as inappropriate). We examined this criteria for it's suitability on 1043 samples received at the clinical bacteriology laboratory at the All India Institute of Medical Sciences (AIIMS) for a period of one year (September, 1996 to August, 1997). Four hundred samples were found appropriate while 643 were inappropriate as per recommended criteria. Amongst the 400 appropriate samples, 215 were culture positive and 185 grew normal flora. However, we found that out of 643 inappropriate samples, 195 were culture positive (p < 0.01, statistically significant). The data was further divided into hospitalized and OPD cases. The distribution of culture positive cases in the appropriate samples was again found to be highly significant. It is apparent from our results that an attempt to process an inappropriate sample does not provide useful information.

Bacteriological Techniques↗
PubMed1998

Outbreak of nosocomial Acinetobacter baumannii bacteremia in a high risk ward.

Acinetobacter baumannii is emerging as a major cause of nosocomial infections particularly in high risk patients. Being resistant to adverse environmental conditions, it can stay for prolonged periods in the hospital environment. We report an outbreak in the medical oncology ward where nine patients suspected of bacteraemia were blood culture positive for A. baumannii from the two samples each, one collected through the i.v. cannula and another through the peripheral veneous puncture. The bacteria was also isolated from the environmental sources from the various samples collected. The biotype, antibiogram, cellular protein profiles on SDS-PAGE and the restriction enzyme analysis patterns of the patient isolates and the environmental isolates were similar. This points to the environment as a source of infection. With reinforcement of proper barrier nursing and use of disposable heparine ampoules it was possible to control the outbreak.

Acinetobacter Infections↗
PubMed1998

In vitro activities of ampicillin-sulbactam and amoxicillin-clavulanic acid against Acinetobacter baumannii.

In vitro susceptibility patterns of newer beta-lactamase-inhibiting antibiotics ampicillin-sulbactam (A/S) and amoxicillin-clavulanic acid (A/C) for 100 consecutive isolates of Acinetobacter baumannii obtained from various clinical samples were studied. The A/C MIC for 86% of the strains was more than 16/8 microgram/ml, whereas there was an A/S MIC of more than 16/8 microgram/ml for only 38% of the strains. This showed that A/S has significantly superior in vitro activity compared to A/C against A. baumannii, although, theoretically, both should have similar activities. The therapeutic superiority of A/S over A/C needs to be studied, or else the breakpoints for these agents in in vitro tests need to be redefined.

Acinetobacter↗
PubMed1998

Influence of iron on growth and extracellular products of Acinetobacter baumannii.

Iron is an important nutrient required by bacteria for optimal growth. Acquisition of iron from the host where iron is restricted is an important mediator of bacterial pathogenesis. In iron deplete chemically defined medium (CDM-Fe) growth of Acinetobacter baumannii was restricted as compared to iron replete medium (CDM + Fe). Bacteria developed four high molecular weight outer membrane proteins (OMPs) of 88, 84, 80 and 77 kDa in CDM-Fe medium which were absent in CDM + Fe medium, and are known iron regulated outer membrane proteins (IROMPs). A. baumannii secreted siderophores extracellularly into the medium which act as iron chelators which had been demonstrated in the supernatants of CDM-Fe media. The siderophore was of catechol type. This shows that A. baumannii under iron restricted conditions express IROMPs along with production of catechol type siderophore in order to acquire iron from the external milieu.

Acinetobacter↗
PubMed1997

Immunopotentiating compounds from Tinospora cordifolia.

The active principles of Tinospora cordifolia a traditional Indian plant were found to possess anticomplementary and immunomodulatory activities. Syringin (TC-4) and cordiol (TC-7) inhibited the in vitro immunohaemolysis of antibody-coated sheep erythrocytes by guinea pig serum. The reduced immunohaemolysis was found to be due to inhibition of the C3-convertase of the classical complement pathway. However, higher concentrations showed constant inhibitory effects. The compounds also gave rise to significant increases in IgG antibodies in serum. Humoral and cell-mediated immunity were also dose-dependently enhanced. Macrophage activation was reported for cordioside (TC-2), cordiofolioside A (TC-5) and cordiol (TC-7) and this activation was more pronounced with increasing incubation times.

Adjuvants, Immunologic↗
PubMed1996

Rapid regulation of neurite outgrowth and retraction by phospholipase A2-derived arachidonic acid and its metabolites.

Arachidonic acid and lipoxygenase metabolites have been proposed to act as retrograde synaptic messengers and as early mediators of neuronal injury, but few studies have analyzed their roles in controlling neurite behavior within a time window of minutes to hours. Phospholipase A2 inhibitors (BPB, ONO-RS-082, quinacrine and AACOCF3) and the lipoxygenase inhibitor AA861 delayed the initial outgrowth of NG108-15 cell neurites on laminin. Inhibitors of diacylglycerol lipase (RHC 80267), cyclooxygenase (indomethacin) and free radicals (N-acetyl cysteine and vitamin E) did not produce similar effects. Phospholipase A2 and lipoxygenase inhibitors also prevented acute neurite retraction in response to lysophosphatidic acid and eight other agents tested, and decreased F-actin staining at cell margins. Conversely, exogenous arachidonic acid (1 microM) enhanced the responses of neurites in outgrowth and retraction assays. Phospholipase A2 and lipoxygenase pathways appear to have a general role in maintaining the ability of neurites to respond rapidly to external stimuli, possibly via regulating the ability of the cytoskeleton to remodel.

Actins↗
PubMed1995

Effect of oleanolic acid on complement in adjuvant- and carrageenan-induced inflammation in rats.

The present work was aimed at evaluating the influence of oleanolic acid on complement-related inflammation. In adjuvant-induced arthritis and carrageenan-induced paw oedema in rats, oleanolic acid was found to possess significant anti-inflammatory and complement-inhibitory activities. The intraperitoneal injection of oleanolic acid (60 mg kg-1, twice a day), before and after Freund's Complete Adjuvant challenge and thereafter repeated for several days, significantly reduced foot-pad thickness of experimental animal models and simultaneously reduced complement activity. Oleanolic acid also produced marked reduction in complement levels and inflammatory effects on carrageenan-induced paw oedema in rats when injected intraperitoneally (60 mg kg-1, twice a day).

Animals↗