Showing 569 results for Research Article: Original Paper
Anuradha Saini , Anjali Sharma , Mukul Singh , Shaily Goyal , Maninder Narang , Sunil Ranga ,
Volume 19, Issue 3 (5-2025)
Abstract
Background: Sepsis stands as a leading cause of mortality among critically ill patients in intensive care units (ICUs). Bacterial infections, including sepsis, upregulate Neutrophilic cluster of differentiation 64 (nCD64) expression on activated polymorphonuclear leukocytes (PMNs). Prompt diagnosis of sepsis is crucial for initiating timely and targeted treatment. Consequently, a rapid laboratory test with high specificity for sepsis in adults would significantly aid therapeutic decision-making and help reduce the overuse of antibiotics.
Methods: This study enrolled 40 sepsis patients diagnosed according to the Sepsis-3 definition. For biomarker evaluation, 2 mL blood samples were collected from each patient in both ethylenediaminetetraacetic acid (EDTA) and plain vials. In addition, nCD64 was analyzed using flow cytometry, high-sensitivity C-reactive protein (hs-CRP) via nephelometry, and procalcitonin (PCT) using chemiluminescence.
Results: For sepsis prediction, nCD64 demonstrated a positive predictive value (PPV) of 92.68% and a negative predictive value (NPV) of 94.87%. A receiver operating characteristic (ROC) curve was generated to assess the diagnostic accuracy of nCD64 (≥ 1.8), hS-CRP (≥ 3 mg/L), and PCT (≥ 0.4 ng/mL). The area under the curve (AUC) for nCD64 was highest at 0.938 (95% confidence interval [CI] = 0.876-0.999), followed by hS-CRP at 0.888 (95% CI = 0.807-0.968) and PCT at 0.850 (95% CI = 0.759-0.941).
Conclusion: These findings strongly suggest that nCD64 determination is a valuable diagnostic tool for identifying infections in patients with septic syndrome. Its performance appears to be superior to that of hs-CRP and PCT.
Sahar Siddiqui , Mohd Suhail Lone , Umar Amin Qureshi , Rayees Khanday ,
Volume 19, Issue 3 (5-2025)
Abstract
Background: Staphylococcus aureus (S. aureus) is a virulent bacterium responsible for a spectrum of infections, from superficial dermatological issues to severe, life-threatening sepsis. The emergence of methicillin-resistant S. aureus (MRSA) strains, encompassing both hospital-acquired (HA) and community-acquired (CA) variants, presents significant challenges to effective treatment, especially in pediatric sepsis cases. This research endeavored to characterize S. aureus sepsis in pediatric patients, differentiate between cases caused by CA S. aureus (CA-SA) and HA S. aureus (HA-SA), and evaluate patterns of antibiotic resistance.
Methods: This study, conducted between January 2021 and December 2022 at the Postgraduate Department of Pediatrics, Children’s Hospital, Srinagar, Kashmir, J&K, investigated patients aged 1 month to 18 years with suspected S. aureus sepsis or disseminated disease. Standard methods (BacT Alert and Vitek II Compact) were employed for culturing various samples. Continuous data are presented as mean ± standard deviation (SD), while categorical variables are expressed as proportions.
Results: Out of 56 patients, CA-SA was observed in 66.1% of cases, while HA-SA accounted for the remaining 33.9%. The cohort primarily consisted of males (62.5%) and individuals residing in rural areas (71.43%). Localized musculoskeletal symptoms were a prominent feature, present in 91.9% of patients (P ≤ 0.05). Pleuropulmonary disease showed an association with HA-SA, whereas necrotizing soft tissue infections were linked to CA-SA. Common clinical manifestations included pneumonia and abscesses. Complications (such as septic shock, respiratory failure, and multi-organ dysfunction) were more frequently encountered in patients with HA-SA. Among 50 culture-confirmed cases, 96% were identified as methicillin-resistant S. aureus (MRSA). Survival rates differed between the two groups, with 94.6% for CA-SA patients and 89.5% for HA-SA patients.
Conclusion: The current study reveals a high prevalence of MRSA in pediatric sepsis, emphasizing the critical need for urgent antimicrobial stewardship. The observed distinct clinical profiles of CA-SA and HA-SA further underscore the necessity for tailored management strategies, particularly in resource-limited environments.
Yashica Gowda R, Suja Ajoy Kumar, Karthik Srevatsa,
Volume 19, Issue 4 (7-2025)
Abstract
Background: The significance of blood transfusion is best captured by the phrase, "It's not just blood-it's liquid life." However, without proper safety measures, transfusion carries serious risks, including the transmission of highly infectious diseases. Among these, hepatitis B virus infection poses a major public health threat due to its high infectivity, potential for chronic infection, and severe complications. Despite the availability of an effective vaccine, hepatitis B virus remains a persistent challenge in transfusion medicine, underscoring the need for stringent screening and preventive strategies. This study aimed to determine the trend of hepatitis B surface antigen (HBsAg) seropositivity among the blood donor population over five years and its prevalence among voluntary and replacement donors.
Methods: This study was conducted at a licensed blood center of a tertiary care hospital. A retrospective review of blood donor data over five years was extracted. All donated blood was screened for the presence of HBsAg using commercially available ELISA kits. All repeatedly reactive samples were labelled seropositive. The data were analyzed for trends in the prevalence of HBsAg over the study period.
Results: A total of 18,139 healthy donors were screened during the study period. Among them, 11,517 were replacement donors and 6,622 were voluntary donors. The overall prevalence of HBsAg seropositivity was 0.66%, which was higher in replacement blood donors (0.46%). A decline in the incidence of HBsAg among donors was also observed over the five-year study duration.
Conclusion: Promoting and encouraging voluntary blood donation is a simple and effective way to reduce the prevalence of all transfusion-transmitted infections.
Sarah Ahmed Hasan, Waad Mahmood Raoof, Khaled Khalil Ahmed,
Volume 19, Issue 4 (7-2025)
Abstract
Background: Carbapenems are broad-spectrum β-lactam antibiotics, often reserved as last-line treatment for infections caused by multidrug-resistant (MDR) Gram-negative bacteria. Carbapenemase producing organisms (CPOs) pose a serious public health threat, contributing to severe healthcare-associated infections and increased mortality rates. This study aimed to determine the prevalence of CPOs and their antibiotic resistance patterns in isolates from burn and wound infections.
Methods: A total of 250 clinical samples (140 wound swabs and 110 burn swabs) were collected from hospitalized patients in Kirkuk and Sulaimaniyah hospitals between January and July 2023. Specimens were cultured on MacConkey agar and cetrimide agar and incubated at 37°C for 18–24 hours. Bacterial identification and antimicrobial susceptibility testing were performed using the BD Phoenix™ M50 system, while carbapenemase production was confirmed using the BD RAPIDEC® CARBA NP assay.
Results: Among the isolates, 27 (38.02%) were confirmed as carbapenemase-producing and exhibited multidrug resistance. The distribution was as follows: Pseudomonas aeruginosa (44.44%, 12 isolates), Escherichia coli (33.33%, 9 isolates), Enterobacter cloacae (18.51%, 5 isolates), and Klebsiella pneumoniae (3.7%, 1 isolate). Notably, CP-P. aeruginosa and CP-K. pneumoniae showed the highest resistance, being resistant to 15 antibiotics across seven different classes.
Conclusion: This study reveals a high prevalence of MDR CPOs in burn and wound infections, likely due to antibiotic misuse or overuse. The findings highlight the urgent need for novel therapeutic strategies to combat carbapenem-resistant pathogens, which are associated with increased global morbidity and mortality.
Karthiga Vj , Arthy Raman , Subhashini Ramamoorthi , Debasis Gochhait , Sreerekha Jinkala ,
Volume 19, Issue 4 (7-2025)
Abstract
Background: Conventional Tissue Processing (CTP) is the gold standard method for tissue processing; however, the method is relatively time-consuming. Microwave Tissue Processing (MTP) reduces the turnaround time and gives comparable histomorphology to CTP. The objective was to compare the Laboratory-grade Microwave Processing (LMP) and Domestic Microwave tissue Processing (DMP) with CTP in terms of histomorphology and immunohistochemistry (IHC) staining.
Methods: Three tissue bits from 89 formalin-fixed resection specimens received in the histopathology laboratory were processed by CTP, LMP, and DMP processing methods. The specimens were fixed in 10% neutral buffered formalin for 24 hours. The sections were stained with Hematoxylin and Eosin (H and E) stain. In subgroup analysis, IHC was done on 17 relevant cases using two antibodies, Ki67 (Nuclear) and Pancytokeratin (Membranous and cytoplasmic). Parameters such as the clarity of section, cytoplasmic details, nuclear details, color intensity, and interface of epithelium and connective tissue were studied. Parameters like color intensity, localization of antigen, background staining, and crispness of staining were studied on IHC. The results were analyzed using Kappa statistics.
Results: There was a fair to moderate agreement between CTP and LMP. There was a slight to fair agreement between CTP to DMP and LMP to DMP.
Conclusion: Microwave tissue processing reduced the turnaround time. The overall quality of LMP tissue was better than DMP and was equally good as that of CTP.
Shayosree Sarkar, Sonal Chavan, Geetika Agrawal, Heena Rahangdale, Sunanada Zodpey,
Volume 19, Issue 4 (7-2025)
Abstract
Background: Burkholderia cepacia complex (BCC) is an opportunistic nosocomial pathogen known to cause severe infections in neonates, including those affecting the respiratory and urinary tracts, as well as bloodstream infections. Consequently, BCC has the potential to instigate outbreaks originating from various sources. This study was undertaken to facilitate the early detection and effective control of a BCC-related outbreak.
Methods: A cross-sectional study, conducted in July 2023 at a tertiary care hospital, investigated bacterial isolates from neonates. Over a one-month period, eleven neonates' blood cultures grew motile, oxidase-positive, non-fermenting gram-negative bacilli. These isolates were presumptively identified as BCC based on conventional biochemical tests and their antimicrobial susceptibility profiles. The recurring isolation of an identical bacterial strain within the neonatal intensive care unit (NICU) strongly suggested an ongoing outbreak. Consequently, active surveillance was initiated to identify the source of the infection and implement containment measures. The identity of the isolated strains was subsequently confirmed using the VITEK 2 Compact microbiology analyser (BioMérieux, France).
Results: Surveillance identified the BCC sources for all 11 affected neonates. The investigation traced the infection origins to several environmental factors within the healthcare setting, including intravenous (IV) catheters and neonatal cradles, operating theatre (OT) beds, and instrument trolleys in the labour room where the deliveries occurred. Furthermore, all environmental BCC isolates demonstrated genetic relatedness to the clinical isolates concurrently exhibiting a similar antibiotic susceptibility pattern. Timely interventions were instrumental in controlling the outbreak.
Conclusion: This study highlights the critical role of the hospital infection control team in effectively managing a BCC outbreak among neonates.
Subaida Adalam Kunnath, Anandan Kalarikal Raghavan, Feroze Moosa , Aneesha Asok Kumar ,
Volume 19, Issue 5 (9-2025)
Abstract
Background: COVID-19 is a global pandemic caused by Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2). Various clinical and hematological findings have been identified that can predict disease severity. This study aims to investigate the roles of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-platelet ratio (NPR) in predicting the severity of COVID-19 infection.
Methods: In this analytical cross-sectional single-center study, after obtaining Ethics Committee clearance, patients with laboratory-confirmed COVID-19 infection admitted during their first two weeks of illness were included. NLR, PLR, and NPR were derived from the CBC reports. These ratios were compared in each clinical category group to assess the severity.
Results: The total number of cases was 160, with a mean age at diagnosis of 56 years. The proportion of males was slightly higher (54.4%) than that of females (45.6%). The proportion of Category C patients (66.9%) was higher than that of Category B (25%) and Category A (8.1%) patients. It was found that NLR, PLR, and NPR ratios had a statistically significant association with severe COVID-19 infection, suggesting they can be used to differentiate between Category C and Category A or B. NLR is a better predictor of the severity of COVID-19 disease than PLR and NPR.
Conclusion: NLR, PLR, and NPR ratios can serve as predictive markers of disease severity in COVID-19 infections. Among these ratios, NLR has the highest predictive value for disease deterioration.
Faeze Shahriyari , Seyyede Fatemeh Shams , Mehrnaz Abdolalian , Narjes Soltani , Hashem Honari , Leila Rafaty Javanbakht, Mohammadreza Javan ,
Volume 19, Issue 5 (9-2025)
Abstract
Background: Blood transfusion services are responsible for providing blood products. Knowing the parameters that affect people’s decision to donate blood will help respond to this demand. This study was designed to assess the attitudes and barriers toward blood donation among volunteer donors in Mashhad (Northeast of Iran) during 2014-2015.
Methods: This cross-sectional study was performed in Iranian Blood Transfusion Organization centers in Mashhad. A total of 640 volunteer blood donors, including first-time and frequent donors, attended this study. The questionnaire was designed based on similar studies, and the reliability and validity were controlled. A questionnaire consisting of multiple-choice questions was provided to the participants. SPSS software was used for data analysis. The Student’s t-test was used, and P<0.05 was considered significant.
Results: Among the 640 participants, 80% completed and returned the questionnaire. Of the participants, 474 (92.5%) were male and 38 (7.4%) were female. A total of 114 donors were first-time donors, and the others had donated blood before. The most important motivations for blood donation included altruism: 249 (91.88%) among frequent donors and 76 (85.40%) among first-time donors. Other factors such as social influences also played a role. Lack of time (73.80%) was the most important barrier to blood donation among the first-time donors.
Conclusion: The results showed that the most important motive and barrier for blood donation were altruism and lack of time, respectively. In other words, paying attention to the motivations and barriers of blood donation can play an important role in attracting and retaining blood donors.
Kavitha Prabhu , Rashmi Theresa Dsouza , Santhosha Devadiga , Beena Antony , Meena Dias ,
Volume 19, Issue 6 (11-2025)
Abstract
Background: Candida species are responsible for substantial morbidity and mortality among susceptible populations. Contemporary epidemiological data indicate a noticeable shift in infection trends away from Candida albicans (C. albicans) toward non-albicans Candida (NAC) species. The primary objectives of this research were therefore to identify the prevalent Candida species and to assess the efficacy of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) for the identification of these species.
Methods: The standard protocol was employed for processing all routine clinical samples submitted to the bacteriology and mycology departments. Identification of Candida species isolated from diverse clinical specimens was performed using MALDI-TOF MS between September 2022 and November 2023. Subsequently, these findings were recorded in tables and subjected to statistical analysis.
Results: During the study period, a total of 342 Candida species were isolated. Patients diagnosed with candidiasis had a median age of 46.5 years and exhibited a male predominance. NAC species were the most frequently isolated group, with Candida tropicalis (C. tropicalis) (30.40%) as the most common species, followed by Candida parapsilosis (C. parapsilosis) (14.32%). Furthermore, 40 strains of Candida auris (C. auris) were identified over the 15-month duration of the study (11.69%).
Conclusion: The significance of Candida species, encompassing both NAC and novel, emerging drug-resistant strains, necessitates a cautious approach. Compared to conventional and automated systems that rely on biochemical reactions for the speciation of Candida isolates, MALDI-TOF MS offers a potentially advantageous alternative due to its rapid and accurate results.
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