iNVISIBLE YET iNVINCIBLE

Flowcytometry Solutions

noreply@blogger.com (Dr RV) — Wed, 24 Apr 2013 04:13:00 +0000

Flowcytometry Solutions (FlowSols – www.flowsols.com) aims at providing complete solution to the researchers and clinicians on flow cytometry. Having started off as an organization to provide the required support in the field of flow cytometry in India and neighboring countries, its mission is to provide a complete flow cytometry expertise, which can help researchers to innovate, lead and excel.

Flow Cytometry is widely used in basic and clinical research and to harness the real power of this complex and rapidly evolving state of art technique, formal training in flow cytometry is paramount. FlowSols strives to provide researchers with the required insight about the core concepts of flow cytometry, thereby helping to perform your experiment/ understand the reports with greater ease and troubleshoot the experimental/ instrument related glitches.

Highlights of FlowSols

To provide basic and advanced training.
To provide researchers with customized flow cytometry training according to their experimental needs.
To provide help with flow cytometry data analysis, interpretation and generation of flow cytometry figures for data presentation and manuscripts.
To provide consultancy on designing the flow cytometry experiment.
Flow cytometry training for new hires and for researchers new to the field.
Training for flow cytometry data analysis software like FlowJo
Training for ICCE certification examination (certified cytometrist)
The above-mentioned services can be provided onsite.

FlowSols website also has the following contents:

Educational resource for flow cytometry - basics and applications of flow cytometry.

List of vendors, who provide flow cytometry reagents, instruments and softwares.

Enquiry form, which can be used to post a query. FCS files can be uploaded to this enquiry form.

Latest News, Updates about flow cytometry happenings in India and other countries.

Clickable useful links for flow cytometry learning and education.

For more information or queries, FlowSols can be reached at: info@flowsols.com or ha@flowsols.com.

Image courtesy: www.flowsols.com

keywords: Flow cytometry, Flowcytometer, flowcytometer, flowjo, FlowJo, Treestar, Immunology, Beckman Coulter, Becton Dickinson, BD, Coulter,

ICMR Junior Research Fellowship 2013

noreply@blogger.com (Dr RV) — Sat, 06 Apr 2013 05:58:00 +0000

APPLICATION FORMS SHALL BE AVAILABLE FROM: 30.3.2013

LAST DATE OF RECEIPT OF APPLICATION FORMS: 30.4.2013

ICMR in collaboration with PGIMER, Chandigarh will hold a National level examination for the award of Junior Research Fellowships (JRF), for Indian national candidates at Bhopal,Bhubaneshwar, Chandigarh, Chennai, Delhi, Kolkatta Mumbai, Guwahati, Hyderabad and Varanasi on Sunday, July 14,2013.

A total of 150 Fellowships would be awarded; 120 fellowships awarded in Life Sciences stream (like microbiology, physiology, molecular biology, genetics, human biology, biotechnology, biochemistry, bioinformatics, biophysics, immunology, pharmacology, zoology, environmental sciences, botany, veterinary sciences ), and thirty (30) fellowships in social sciences stream (like Psychology, Sociology, Home Science, Statistics, Anthropology, Social work and Health Economics).

Application form duly completed must reach the Professor Incharge (Academic Section)

PGIMER, Chandigarh-160012 by registered/Speed post on or before 30.4.2013. Candidate from

remote areas /regions may submit their application forms duly completed latest by 10.5.2013.

Eligibility:

Educational: M.Sc/M.A or equivalent degree with minimum 55% marks for General/OBC Candidates and 50% for the SC/ST & physically handicapped (PH) candidates in the subjects mentioned above.

Candidates appearing in the final year examination (2013-2014) can also apply.

Age Limit: The upper age limit for admission to the eligibility test is 28 years as on 30-09-2013 (relaxable up to 5 years in case of candidates belonging to SC/ST/PH/ female candidates and 3 years in the case of OBC.

Information bulletin containing the application form and other details will be available at ICMR New Delhi website : icmr.nic.in . The candidate is required to download the Application Form/Challan Form from the PGIMER Website http://pgimer.nic.in and ICMR New Delhi website http://icmr.nic.in only. After filling the application form the candidate is required to send it by Speed Post/Registered Posts to Registrar, PGI, Chandigarh on or before 10.5.2013. (for General & OBC Rs. 500/- and Rs. 300/- for SC/ST/PH)

NOTE: No request for supply of form by post will be entertained after 30.4.2013

Click here for more details.

SRF Wanted for the Dept. of Microbiology, Govt. Theni Medical College

noreply@blogger.com (Sekar) — Sat, 30 Mar 2013 16:20:00 +0000

Applications are invited on plain paper for the purely temporary post of Senior Research Fellow in the ICMR funded project as per details given below:-

Name of the Post: Senior Research Fellow
Number of Post: One position
Project Title: Cross sectional study on Epidemiology and Mechanisms of Carbapenem resistance among Enterobacteriaceae members
Duration of the Project: Three years
Essential Qualification: M.Sc. Microbiology with 2 years research experience.
Upper Age Limit: 28 years (Relaxable in case of SC/ST/OBC/PH/Women candidate as per rules).
Remuneration: Rs.18000 + 10% HRA per month.

The appointment in the project is purely on temporary basis. The appointment will be made on consolidated pay initially for a period of 12 months, likely to be extended on the basis of their performance for next year till end of the study period.

Interested candidates fulfilling the above criteria are required to submit their complete bio-data duly signed and enclosed with photocopies of certificates/testimonials in support of date of birth, qualification/experience etc. & affixed with latest photograph, by 06-May-2013 to the office of the undersigned.

Interview of the shortlisted candidates will be conducted on a suitable date in the office chambers of the undersigned. Candidates will be informed accordingly. No TA/DA shall be paid for attending the interview.

Dr. KM. Mythreyee., M.D.,
Professor & Head
Department of Microbiology
Govt. Theni Medical College
Theni – 625512
Tamil Nadu.

Microbiology Educational Resource

noreply@blogger.com (Dr RV) — Sat, 23 Mar 2013 07:34:00 +0000

e-Bug (www.e-bug.eu) is a free educational resource for classroom and home use and makes learning about micro-organisms, the spread, prevention and treatment of infection fun and accessible for all students.

Online Microbiology games
Revision pages
Microbiology Gallery
Microbiology Animations
Detailed lesson plans
Fun student worksheets
Extension activities
Activity demonstrations
MS PowerPoint presentations to assist with the more difficult aspects of microbiology.

Curious Case of Mississippi Baby Cured of HIV

noreply@blogger.com (Dr RV) — Wed, 06 Mar 2013 22:35:00 +0000

According to the United Nations estimate, in 2011, 330,000 babies were reported to be newly infected with HIV and globally more than 3 million children are living with HIV.

Dr. Deborah Persaud, an associate professor at the Johns Hopkins Children’s Center and his team of researchers recently announced that a baby had been cured of HIV infection. The results were discussed in the 20th CROI (Conference on retroviruses and opportunistic infections) 2013 at Atlanta and have not yet been published in a journal. According to the researchers, if this case could be replicated, it is a proof principle that HIV infection can be cured and this finding could be a milestone in research aimed at curing HIV, which was believed to be virtually impossible.

If this report gets confirmed, this baby from rural Mississippi would be the second case known to have completely cured of HIV infection, Timothy Brown, famously known as the 'Berlin patient' being the first documented case. Most experts in the field are skeptic over this curious case and ask for more convincing details if the baby had truly been infected in the first hand and in case if it was, could this finding be replicated in other babies? But Dr. Persaud claim that the baby had definitely been infected and there were five positive tests confirming the infection. And as the baby was treated aggressively with ART right from 30 hours following birth, the plasma viral load of the baby declined in the pattern that is characteristic of infected patients. The baby, now a two and a half years old toddler has been off drugs for an year with no sign of virus and Dr. Persaud has little doubt that the baby had undergone a “functional cure”.

Though there have been scattered cases reported in the past about newborns clearing the virus, even without treatment, they were met with skepticism, because, the methods were not very much sophisticated those days. One reason that people infected with HIV cannot be cured is that it hides in a dormant state, out of reach of drugs and when therapy is stopped, the virus goes on to come out of hiding. One hypothesis put forth for this case of 'HIV cure' in the baby is that, the drugs finished off the virus before it had the opportunity to establish a reservoir in the body. In case of adults, they do not know when they are infected as it happens.

Studies are being planned to investigate if early testing and aggressive antiretroviral treatment can work similar results for other babies. This Mississippi baby treatment procedure, not being as strenuous and life-threatening as the bone marrow transplant procedure that cured the Berlin patient, could possibly become a new standard of care and this interesting finding could lead to a new protocol to quickly test and treat infants.

Most Asked Job Interview Questions & How to Answer Them?

noreply@blogger.com (Dr RV) — Mon, 18 Feb 2013 08:38:00 +0000

This infographic presents the important questions that are asked in most of the job interviews and also the ways to answer them aptly

Click on the image for larger size infographic

Infographic Courtesy Sample Questionnaire
Most Asked Job Interview Questions and How to Answer Them?

Super Yeast?

noreply@blogger.com (Dr RV) — Fri, 15 Feb 2013 07:55:00 +0000

Hospital acquired candida infections are gaining significance worldwide. Candida is a well known etiological agent causing blood stream infections, associated with high mortality rates.

A team of microbiologists from Sir Ganga Ram Hospital, New Delhi retrospectively investigated the trend in the epidemiology of candidaemia and the use of antifungal agents at a tertiary care hospital, over a period of 10 years and the results are published in the recent issue of Indian Journal of Medical Research.

The frequency of candidaemia occurrence and the antifungal use were observed to be significantly higher. elevated. Blood stream infections caused by species of Candida other than Candida albicans were observed to be on the rise and this increase was found to be correlating with increasing usage of fluconazole. The researchers have noted increased isolation and emergence of Candida haemulonii, a novel species of Candida which was most isolates of these were found to exhibit decreased susceptibility to amphotericin B and azoles.

This observation of a shift in epidemiology of candidemia to non-albicans Candida species and the emergence of amphotericin B and azole resistant strains are causes of severe concern and call for immediate action towards judicious use of these antifungal agents.

Reference: Oberoi, J. K., Wattal, C., Goel, N., Raveendran, R., Datta, S., & Prasad, K. (2012). Non-albicans Candida species in blood stream infections in a tertiary care hospital at New Delhi, India. Indian Journal of Medical Research, 136(6), 997. http://www.icmr.nic.in/ijmr/2012/december/7.pdf

Related Posts:

Candida - An Emerging Pathogen

Operation Theatre Surveillance

noreply@blogger.com (Dr RV) — Wed, 13 Feb 2013 10:55:00 +0000

Role of Microbiological Surveillance

The environments in the operation theatre are dynamic and subject to continuous change. Good infrastructures do not mean a safe environment as human make a greater difference in making the environment unsafe.

Microbiologists should be aware of organisms, sites and populations as surveillance cultures should be chosen carefully to allow meaningful interpretation of results. Microbiologists should be familiar with the clinical techniques as those normally used for culturing clinical specimens may not yield correct result when applied to environmental specimens. Sites and cultured reports should not be chosen as etiological sources in the present infections. Culturing unnecessary surface areas causes confusion and meaningful interpretation is lost.

AIR IS THE IMPORTANT SOURCE OF INFECTION

Bacterial counts in operation theatres are influenced by the number of individuals present, ventilation and air flow, the results should be interpreted taking the above facts into consideration.

Surveillance for Airborne Pathogens:

In resource poor hospitals, settle plates with blood agar are used and can detect pathogens, commensals and saprophytic bacteria. Multiple plates are kept and results are based on overall assessment rather than on a single plate study in the room. Microbiologists will clarify the acceptable counts at the different physical locations in multispecialty hospitals.

There is a sea change in analysis of bacterial counts in recent past with advances in medical technologies like Joint replacement surgeries dealing with critical patients. Slit sampler and Air centrifuge equipment for bacterial counts are replacing settle plates, the safe level of colony counts can be calculated as per the standards created with peer reviewed studies by the manufacturers.

How frequently should Surveillance be done for Airborne Microbes?

Yet there is no definite answer to this question!

Doing too frequent surveys are expensive and will not correlate the existing infection rate in the Hospital. But can indicate the circumstance we operate which can have bearing effect if the safety standards fall. Surveillance for Clostridia spores may be needed. The age old tradition of detection of anaerobic spores of C.tetani, and Gas gangrene producing organisms are losing ground with onset of more awareness on theatre sterilization. Routine testing for the anaerobes are not essential except when there were suspected cases of Tetanus or Gas gangrene attributed to operating in a particular operation theatre.

But it is ideal to survey the operation theatres for anaerobes when newly constructed or any remodelling or structural alterations are done. In such situations which will have trust worthy safety of the theatre.

General Instructions for sterilization and disinfection of Operation theatres

Keep the floor dry when in use.
Use only vacuum cleaners (booming to be forbidden as it will dispense the infected material all around and on the equipments.
Chemical disinfection of an operation room floor is probably unnecessary. The bacteria carrying particles already on the floor are unlikely to reach an open wound in sufficient numbers to cause an infection.
Cleaning alone followed by drying will considerably reduce bacterial population.
Wall and Ceilings - Wall and ceiling are rarely contaminated. The numbers of bacteria do not appear to increase even if walls are not cleaned. Frequent cleaning is not necessary and has little influence on bacterial counts. Routine disinfection is therefore unnecessary, but only cleaned when dirty.

Environmental cleaning of Operation theatres:

At the Beginning of the Day

Only remove the dust with cloth wet with clean water. (Mop theatre furniture lamps, sitting tables, trolley tops, operation tables, procedure tables, and Boyle’s apparatus). Note: Chemicals/disinfectants need not be used unless contaminated with blood or body fluids.

Between the procedures

Clean operation tables or contaminated surfaces with disinfectant solutions.
In case of spillages of blood/ body fluids decontaminate with bleach solution/ chlorine solution (10% available chlorine)
Discard all waste in colour coded plastic bags (do not accumulate around surgical sites)
Do not discard soiled linen and gowns in the operation theatre floor.

At the end of the day

Clean all the table tops, sinks, door handles with detergent followed by low level disinfectant.
Clean the floors with detergents mixed with warm water.
Finally mop with disinfectant like phenol in the concentration of 1 in 10 (low concentrations of phenol will not serve the purpose).
Keep the operation theatre dry for the next day's work.

Operation Theatre Discipline:

Only people absolutely needed for an assigned work should be present in the Operation Theatres
People present in theatre should make minimal movements and curtail unnecessary movements in and out of theatres, which will greatly reduce bacterial count.
Air borne contamination is usually affected by type of surgery, quality of air which in fact depends on rate of air exchange.
All the persons including the least cadre of employers are partners in infection control and should be aware to comply with infection control regulations.
Prompt disposal of Theatre waste out of the theatre is of top priority. Any spillage of body fluids on the floors is highly hazardous and prompts the rapid multiplication of nosocomial pathogens.

- Prof.T.V.Rao MD

Bibliography

1 Principles and Practice of Disinfection, Preservation and Sterilization, 3rd edn. A. D. Russell, W. B. Hugo, G. A. J. Ayliffe, Eds. Blackwell Scientific Ltd., Oxford, 1999. ISBN 063 2041 43,

2 Patwardhan, Narendra, and Uday Kelkar. "Disinfection, sterilization and operation theater guidelines for dermatosurgical practitioners in India." Indian Journal of Dermatology, Venereology, and Leprology 77.1 (2011): 83.

3 Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008, William A. Rutala, Ph.D., M.P.H.1,2, David J. Weber, M.D., M.P.H.1,2, and the Healthcare Infection Control Practices Advisory Committee (HICPAC)3 (CDC 2008)

About the Author:

The author of this post is a Professor of Microbiology at Travancore Medical College, Kollam, Kerala, India. He can be reached at doctortvrao@gmail.com.

Related Posts:

Operation Theatre Sterilization by Fumigation

Sterilization of OT – Newer Methods to Replace Fumigation

keywords: OT, Operation theatre, Operation theater, OT fumigation, OT sterilization, Fumigation, Formaldehyde fumigation, VIRKON, BACILLOID, Baciloid, virkkon, OT surveillance

Sterilization of Operation Theatres: Newer Methods to Replace Fumigation

noreply@blogger.com (Dr RV) — Wed, 13 Feb 2013 08:05:00 +0000

In spite of brief stay of patients in the operation theatre, the environment of operation theatre plays a great role in the onset and spread of infections, because of multifactor causation of infections. It is usually necessary to study the epidemiology of infection as a multidisciplinary approach. In resource poor circumstances as in most developing countries, people work in isolation and few facilities to make any epidemiological surveys. Many believe that routine Microbiological monitoring is most essential but in reality it is not practicable. But every hospital should pay good attention in proper maintenance of air conditioning plants, ventilator systems, and to have greater control on mechanisms and personnel involved in disinfection and sterilization of materials used in the theatres in operative procedures.

Sterilisation means eradicating germs completely, which is not 100% possible in an operation theatre. The sources of bacterial contamination are from air and the environment, infected body fluids, patients, articles, equipment etc. The following methods are practiced to keep the operation theatre (OT) bacteriologically safe and below accepted levels:

1. Special air flow pattern (the air flow pattern is such that filtered and purified air circulates and contaminated air is removed continuously). There is restriction of personnel traffic, closing of OT doors and a good ventilation system.

2. Standard cleaning, disinfection with appropriate chemical agents, good theatre practice, discipline, can provide a microbiologically safe environment.

Fumigation is an age old process of sterilisation, of the environment, may be a sick room or operation theatres. It is usually done with formalin fumes, which are are very pungent and harmful. So when a room is fumigated, it is tightly closed and sealed before fumigation. The room is opened after fumigation (12 - 24 hours). The room can be used once all fumes are out.

OSHA indicated that formaldehyde should be handled in the workplace as potential carcinogen and set an employee exposure standard for formaldehyde that limits an 8-hour time- weighted average exposure concentration of 0.75ppm. Formaldehyde is the commonly used agent. Formaldehyde gas is generated from liquid formalin utilizing potassium permanganate crystals. 40% formalin liquid is added to potassium permanganate crystals to generate gas. Alternately, formalin liquid can be dispersed by a sprayer like device in the theatre environment. After a contact time of at least 6-8 hours, the formaldehyde needs to be neutralized by using ammonia, allowing at least 2 hours contact time for ammonia to neutralize the formaldehyde prior to the use of theatre.

Fumigation is obsolete in many developed nations in view of toxic nature of Formalin. Too frequent use and inhalation is hazardous. Several new safe chemicals are emerging but constrains of economy limit the use and several hours of closure of operation theatres can be curtailed as with Fumigation.

Aldehydes are potentially carcinogenic and it is therefore recommended that other agents such as hydrogen peroxide, hydrogen peroxide with silver nitrate, peracitic acid and other chemical compounds of formaldehyde should be used in place of the currently prevalent practice of using formaldehyde. These agents are dispersed with the aid of a fogger-like device inside the theatre environment. The contact time is about an hour and the theatre can be used immediately after the contact time.

Emerging Compounds in use for Sterilization of Operation theatres:

Bacillocidrasant:

A newer and effective compound in environmental decontamination with very good cost/benefit ratio, good material compatibility, excellent cleaning properties and virtually no residues. It has the advantage of being a Formaldehyde-free disinfectant cleaner with low use concentration.

Advantages

- Provides complete asepsis within 30 to 60 minutes.

- Cleaning with detergent or carbolic acid not required.

- Formalin fumigation not required.

- Shutdown of O.T. for 24 hrs. not required.

Other Newer and Non Toxic compounds:

A Chemical compound - VIRKON is gaining importance as non-Aldehyde compound. Virkon is proved to be a safe virucidal, bactericidal, fungicidal, mycobactericidal and non-toxic compound. It contains oxone (potassium peroxymonosulphate), sodium dodecylbenzenesulfonate, sulphamic acid; and inorganic buffers. It is typically used for cleaning up hazardous spills, disinfecting surfaces and soaking equipment. Though Virkon is shown to have wide spectrum of activity against viruses, some fungi, and bacteria, it however is less effective against spores and fungi than some alternative disinfectants. Several other compounds are emerging in the Market for safer use, may need better resources for utility and implementation.

- Prof. TV Rao, MD

Bibliography:

1. Principles and Practice of Disinfection, Preservation and Sterilization, 3rd edn. A. D. Russell, W. B. Hugo, G. A. J. Ayliffe, Eds. Blackwell Scientific Ltd., Oxford, 1999. ISBN 063 2041 43,

2. Patwardhan, Narendra, and Uday Kelkar. "Disinfection, sterilization and operation theater guidelines for dermatosurgical practitioners in India." Indian Journal of Dermatology, Venereology, and Leprology 77.1 (2011): 83.

3. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008, William A. Rutala, Ph.D., M.P.H.1,2, David J. Weber, M.D., M.P.H.1,2, and the Healthcare Infection Control Practices Advisory Committee (HICPAC)3 (CDC 2008)

4. Hernndez, A., et al. "Assessment of in-vitro efficacy of 1% Virkon® against bacteria, fungi, viruses and spores by means of AFNOR guidelines." Journal of Hospital Infection 46.3 (2000): 203-209.

5. Gasparini, R., et al. "Evaluation of in vitro efficacy of the disinfectant Virkon."European journal of epidemiology 11.2 (1995): 193-197.

About the Author:

The author of this post is a Professor of Microbiology at Travancore Medical College, Kollam, Kerala, India. He can be reached at doctortvrao@gmail.com.

keywords: OT, Operation theatre, Operation theater, OT fumigation, OT sterilization, Fumigation, Formaldehyde fumigation, VIRKON, BACILLOID, Baciloid, virkkon, OT surveillance

New Antibacterial Drug to Thwart MRSA!

noreply@blogger.com (Dr RV) — Tue, 12 Feb 2013 09:58:00 +0000

Infections by methicillin-resistant Staphylococcus aureus (MRSA), being very hard to treat, remain a challenge to healthcare providers worldwide. Bacterial cell wall synthesis is usually targeted by most classes of antibiotics, since cell wall is essential for the bacteria to survive and these cell wall structures are absent in the hosts (humans). Undecaprenyl diphosphate synthase (UPPS), an enzyme required for early-stage cell wall synthesis is one of the potential targets for drug development and a few studies have already identified compounds inhibiting UPPS.

In a mission to develop newer UPPS inhibitors Dr. Eric Oldfield and colleagues of the University of Illinois and Andrew McCammon of the University of California, San Diego, zeroed in on diverse compounds with activity against UPPS using computer screening programs and then analyzed the 3D structures of compounds bound to enzyme using X-ray crystallography.

Of the 10 compounds identified, the scientists went on to investigate the strongest of the inhibitors and in vitro laboratory investigations revealed that the stronger compounds were active against both Gram negative Escherichia coli and MRSA. One of the potent compounds that was found to improve the efficiency of methicillin was tested on a mice artificially infected with MRSA and 20 out of 20 mice survived, while untreated mice did not. Thus, further research in this direction might lead to effective antibacterial drugs to tackle the ever-increasing threat of infections by resistant bacteria.

Reference: Zhu W et al., Antibacterial drug leads targeting isoprenoid biosynthesis. Proc Natl Acad Sci U S A. 2013 Jan 2;110(1):123-8.

Image: Structure of S. aureus Undecaprenyl Diphosphate Synthase in Complex With FPP and Sulfate. Source: MMDB - Madej T, Addess KJ, Fong JH, et al., "MMDB: 3D structures and macromolecular interactions." Nucleic Acids Res. 2012 Jan; 40(Database issue):D461-4

Improving Single Sputum Smear Microscopy

noreply@blogger.com (Dr RV) — Thu, 27 Dec 2012 08:14:00 +0000

Tuberculosis (TB) continues to be a leading cause of morbidity and mortality globally and HIV/TB co-infection remains a major threat. TB infection in HIV patients has different clinical presentations and manifestations, thereby being a diagnostic challenge as well. AFB sputum microscopy remains the diagnostic test of choice for pulmonary TB in resource-limited settings despite reports of eroded sensitivity in people living with HIV. To improve the chance of detecting AFB by microscopy, national guidelines recommend collection of two sputum specimens instead of one specimen, though providing dual specimens is often a practical challenge for HIV infected individuals.

Hence a team of researchers from Chennai had evaluated if concentrating single sputum specimen could improve the sensitivity of detection of TB by sputum smear microscopy. Considering the increasing number of reports of Mycobacteria other than tuberculosis (MOTT) as opportunistic pathogens in immune-compromised hosts and most MOTT cases tend to be smear negative and culture positive, they had also evaluated the performance characteristics of concentration method to detect Mycobacterium tuberculosis (MTB) and MOTT rather than AFB detection. The study involved sputum specimens from 146 HIV infected patients and 403 HIV status unknown patients presenting with clinical signs and symptoms for TB. Direct sputum smear and smear from sputum concentrated by modified Petroff’s method were made and stained by Ziehl-Neelsen method. AFB culture was performed by BACTEC TB 460 radiometric method as the reference method. Results of direct, concentrated sputum smear microscopy were compared with AFB culture results in a blinded evaluation. McNemar’s test and two-sample proportion tests were used and statistical analyses were performed using GraphPad Prism ver5.0 and SPSS ver12.0 softwares.

Concentration of single sputum specimen was found to significantly improve the sensitivity of AFB smear microscopy in HIV infected TB suspected cases and also in HIV status unknown TB suspected cases. When the performance characteristics of direct and concentrated single sputum smears in detecting MTB and MOTT were separately analyzed, the concentration method significantly improved the sensitivity to detect only MTB to two-fold among HIV infected subjects. The sensitivity of detecting only MOTT among the HIV infected TB suspected cases plunged to 9.1% and upon concentration of sputum specimen, the sensitivity of detecting only MOTT increased to 36.4%, though not statistically significant. Thus, this sputum concentration method could be helpful to increase the sensitivity of TB diagnosis, particularly for HIV patients in resource-constrained settings with limited access to culture based TB diagnostics.

Reference: Could concentrating single sputum improve the performance of smear microscopy in detecting TB among HIV patients? The Journal of infection.2012; doi:10.1016/j.jinf.2012.09.015.

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1. TDR-TB - No choices left

2. TB Diagnosis - Resources

3. MODS

4. XDR-TB & HIV - The Deadly Duo

Cell separation techniques - Videos & Webinars

noreply@blogger.com (Dr RV) — Fri, 14 Dec 2012 08:19:00 +0000

STEMCELL Technologies Inc is a privately owned biotechnology company that develops specialized culture media, cell separation products and ancillary reagents for life science research.

STEMCELL’s website has wonderful resource of videos and webinars on various practical topics that would be of tremendous use to scientists, such as:

· · Cell separation solutions for HLA and Chimerism analysis

· Fast and Easy Cell isolation in a 96-well plate

· Powerful immunomagnetic isolation of virtually any cell type

· Fast and easy isolation of untouched NK cells

· Fast and versatile isolation of distinct human regulatory T cell subsets

· Fully automated cell separation for chimerism analysis

· A guide to isolating nucleated cells from whole blood

· How to isolate mononuclear cells from whole blood by density gradient centrifugation

· How to perform cell counts with a hemocytometer

· How to prepare a single cell suspension from frozen samples

· How to prepare a single cell suspension from primary tissue samples

· Isolate cells from Leukopaks without density centrifugation

· Isolation of MSCs from mouse compact bone

2. Cryopreservation of PBMCs

Free Online Courses from Top Universities

noreply@blogger.com (Dr RV) — Sat, 29 Sep 2012 08:25:00 +0000

Coursera is a social entrepreneurship education technology company that partners with the top universities in the world (such as Johns Hopkins, University of California, Stanford, Harvard, Brown, Emory, Duke and much more) to offer courses online for anyone to take, for FREE.

Coursera’s technology enables the best professors to teach tens or hundreds of thousands of students, hoping to provide everyone with access to the world-class education that has so far been available only to a select few. By empowering the people with education, that will improve their lives, lives of their families, and the communities they live in. Classes offered on Coursera are designed to help students in mastering the material and when they take one of classes, they will watch lectures taught by world-class professors, learn at their own pace, test their knowledge, and reinforce concepts through interactive exercises.

By joining one of classes, they will also join a global community of thousands of students learning alongside them. Aware of the time constraints and other commitments one might have, the courses are designed based on sound pedagogical foundations, to help master new concepts quickly and effectively. As of August 16, 2012 more than 1,080,000 students from 196 countries have enrolled in at least one course.

Coursera offers courses in a wide range of topics, spanning the Humanities, Medicine, Biology, Social Sciences, Mathematics, Business, Computer Science, and many others.

Click here for the courses in Life Sciences & Biology and here for the courses available in Medicine.

Image: Screenshot from an online course page of Coursera.org

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Mosquitoes Get Smarter!

noreply@blogger.com (Dr RV) — Tue, 25 Sep 2012 05:22:00 +0000

According to the WHO World malaria report 2011, there were about 216 million cases of malaria and an estimated 6,55,000 deaths in the year 2010. Most malaria related deaths occur among children living in Africa where a child dies every minute from malaria. Long-lasting insecticide-treated mosquito nets (LLINs) have revolutionized malaria prevention, and have the potential to save millions of lives and according to an estimate, for every 1,000 children protected by an insecticide-treated net, five to six lives would be saved every year. Thus, WHO recommends the usage of LLINs as a crucial method to combat malaria.

A recent study published in the Journal of Infectious Diseases by Nicolas Moiroux and colleagues from France has revealed that following the usage of LLINs, there is a switch in the biting behavior of the malaria vector mosquitoes. When the mosquito behavior before and after all households in two villages in Benin were given insecticide-treated nets, were investigated, the researchers observed that the mosquitoes seemed to change their peak aggression hours of biting from 2 a.m. or 3 a.m. to around 5 a.m., when the people are usually out of the net, early to work. Moreover, the rates of mosquito bites in the outdoors were observed to be increasing after the years of usage of LLINs. Thus, the outcomes of the study challenge the "dogma" that malaria-transmitting mosquitoes in Africa bite exclusively at night.

However, it is also to be noted that, since the results are from just two villages in one country, this cannot be extrapolated to a wider geographical area and/or a different entomological context.

For further information:

Moiroux N, Gomez MB, Pennetier C, Elanga E, Djènontin A, Chandre F, et al. Changes in Anopheles funestus Biting Behavior Following Universal Coverage of Long-Lasting Insecticidal Nets in Benin. J. Infect. Dis. [Internet]. 2012 Sep 21; Available from: http://www.ncbi.nlm.nih.gov/pubmed/22966127

Reference:

World Health Organization. World malaria report 2011. Geneva, Switzerland: World Health Organization; 2011.

Available at http://www.who.int/malaria/world_malaria_report_2011/en/index.html.

1. Engineered bacteria to combat malaria

Microbiology - In Fingertips

noreply@blogger.com (Dr RV) — Thu, 20 Sep 2012 08:09:00 +0000

Mobile applications or mobile apps, the software application designed to run on smartphones, tablet computers and other mobile devices are recognized as the next-generation resources tool that are literally ‘handy’. These applications are made available through application distribution platforms such as the Apple App Store, Google Play, Windows Phone Store and BlackBerry App World. There are millions and millions are apps available on every possible topic and yes, there are useful apps for Microbiology too.

Click the links below for a compilation of useful Microbiology related applications:

· Microbiology Apps for Android devices

· Microbiology Apps for iPhones & iPads

Related Posts:

1. Ringing in Good news

Animated Flowcytometry Theory - Online Training

noreply@blogger.com (Dr RV) — Wed, 19 Sep 2012 13:34:00 +0000

Flow cytometry is a laser based, bio-physical technology that involves suspending of cells in a thermodynamic stream of fluid and passing them by an electronic detection apparatus. This technology is employed in applications such as cell counting, sorting of cells, biomarker detection and protein engineering and it allows simultaneous multi-parametric analysis of the physical and/or chemical characteristics of up to thousands of particles per second. Flow cytometry has many applications in clinical and basic research.

Beckman Coulter’s website has these on-line training courses, with the five basic components of flow cytometry theory.

· The Art of Sorting

· The Science of Flow Cytometry – Basics I

· The Science of Flow Cytometry – Basics II

· Matrix Simulator

· Flow Principles

· Excitation Emission & Filters

· Filter Selection

· Flow Compensation

· Flow Applications

· Flow Cytometer

Note: These presentations are for Training Use Only and are intended for any operators of the system including but not limited to customers, service engineers, sales, and application specialists.

Related Posts:

1. Flowcytometry Online Tutorial

2. PBMC Cryopreservation - FAQs

HIV “piggy-backs” on infected CD4 T cells!

noreply@blogger.com (Dr RV) — Fri, 03 Aug 2012 06:22:00 +0000

A research study by scientists from Massachusetts General Hospital (MGH) has shown that, not only does HIV infect and destroy CD4 T cells, but also appears to use those cells to travel through the body and infect other CD4 T cells. In this study which is the first to visualize the behavior of HIV-infected human T cells within a lymph node of a live animal, using a recently developed "humanized" mouse model of HIV infection, the researchers have found that HIV disseminates in the body of an infected individual by 'hitching a ride' on the T cells it infects. As the Infected T cells continue to migrate within and between tissues such as lymph nodes, HIV gets a ride to remote locations that are usually not accessible to free viruses.

The scientists used the humanized BLT mouse model for their experiments, the only non-primate that can be infected with HIV. Upon confirming that human T cells enter and normally migrate within the animals' lymph nodes, the researchers injected the animals with HIV that is engineered to express green fluorescent protein (GFP), to track the movement of infected cells within living animals using intravital microscopy. They first observed that, within two days, infected T cells continued to migrate and were uniformly distributed within lymph nodes but remained in nodes closest to the site of injection. As the HIV-infected cells actively moved within lymph nodes, they did not move as quickly as comparable but uninfected T cells. Moreover, about 10 to 20% of the HIV-infected T cells formed abnormally long and thin extensions that appeared to trail behind moving cells, often exhibiting branches.

The researchers thus hypothesized that the HIV envelope protein, expressed on the surface of infected T cells before they release new virus particles, might cause infected cells to form tethering contacts with uninfected cells, causing these extensions. A series of experiments verified that the elongated shape of some infected cells requires the presence of the envelope protein and that many of the elongated cells contained multiple nuclei, suggesting they had been formed by the fusion of several cells. Further, to test the role of T cell migration in HIV infection, the researchers injected another group of BLT mice with HIV and at the same time treated them with an agent that prevents T cells from leaving lymph nodes. Two months later, levels of HIV in the bloodstream and in lymph nodes distant from the site of injection were much lower than in untreated HIV-infected animals, supporting the importance of T cell migration to carry virus throughout the body. Treatment with the migration-suppressing agent, however, did not reduce viral levels in animals with already established HIV infection.

While this observation of tethering interactions between infected and uninfected CD4-expressing cells suggest that HIV may be transmitted between T cells by direct contact, further future studies are needed to explore further and to investigate previously unexplored aspects of HIV pathogenesis.

Reference:

Murooka TT, Deruaz M, Marangoni F, Vrbanac VD, Seung E, von Andrian UH, et al. HIV-infected T cells are migratory vehicles for viral dissemination. Nature [Internet]. 2012 online;advance online publication. Available from: http://dx.doi.org/10.1038/nature11398

Related Posts:

1. HIV Disease progression - Genetic fossils show way!

2. HIV testing of TB suspects

3. When to Start? ART

Engineered bacteria to combat malaria!

noreply@blogger.com (Dr RV) — Thu, 19 Jul 2012 04:59:00 +0000

According to the WHO World malaria report 2011, there were about 216 million cases of malaria and an estimated 655 000 deaths in the year 2010. Most deaths occur among children living in Africa where a child dies every minute from malaria.

A team of scientists at the Johns Hopkins Malaria Research Institute have genetically modified Pantoea agglomerans, a bacterium found in the mosquito's midgut to secrete proteins toxic to the malarial parasite. These toxins do not harm the mosquitoes or humans, but inhibit the development of malarial parasites. They have found that these engineered bacterial strains inhibited the development of Plasmodium falciparum and P. bergheby (rodent malarial parasite) by up to 98% within the mosquito. They also found that the proportion of mosquitoes carrying the parasites decreased by up to 84%. The findings of this study is published in the PNAS (July 16, 2012, doi:10.1073/pnas.1204158109).

This research has demonstrated the use of an engineered symbiotic bacterium to interfere with the development of P. falciparum in the mosquito and these findings provide the foundation for using genetically modified symbiotic bacteria as a powerful tool to combat malaria.

Source: http://www.pnas.org/content/early/2012/07/10/1204158109.abstract

Photo Credit: MEDICAL RF.COM/SCIENCE PHOTO LIBRARY

HIV testing of TB suspects –To improve HIV case detections

noreply@blogger.com (Dr RV) — Tue, 10 Apr 2012 12:42:00 +0000

The World Health Organization (WHO) recommends that patients suspected for TB getting tested for TB should also be tested for HIV. Researchers from India conducted a study to observe how adopting WHO’s HIV/TB testing policy would affect the detection rates of HIV. The study was conducted in the Mandya district of Karnataka, one of the states with high HIV rates and the study findings are published in the recent edition of JAIDS.

HIV testing was offered to 1668 patients tested for TB and 92% accepted and took part in the study. Of these 1539 people, 108 (7%) were tested positive for HIV. The researchers have analyzed that the clinicians would have to screen 37 TB suspected people for HIV to detect 1 HIV infection and would have to screen 13 TB patients in order to detect 1 HIV infection. The researchers have projected that, had this WHO testing policy been in place in the Mandya district in 2010, about 534 new HIV infections (51% jump) would have been identified. The study results underscore the significance in HIV testing for those suspected for TB and demonstrate a major opportunity for improved HIV case finding.

Since patients suspected for TB are an easily accessible population at health care facilities, co-testing for HIV would significantly improve the HIV case detection and the Indian policy makers should explore the possibility of implementing this in states with high HIV prevalence.

For more details:

Naik B, Kumar Mv A, Lal K, Doddamani S, Krishnappa M, Inamdar V, et al. HIV Prevalence Among Persons Suspected of Tuberculosis: Policy Implications for India. Journal of Acquired Immune Deficiency Syndromes (1999). 2012 Apr 1;59(4):e72–e76.

Cytometry by time-of-flight - CyTOF

noreply@blogger.com (Dr RV) — Wed, 04 Apr 2012 10:38:00 +0000

Simultaneous analysis of multiple markers has been made possible with the development of a new method called cytometry by time-of-flight (CyTOF), or mass cytometry. With flow cytometry technology, one can simultaneously analyze up to about 20 different markers. This new CyTOF technology can simultaneously measure about twice as many different cellular markers than flow cytometry can. However, traditional flow cytometry still holds its place than this recent technology because, CyTOF is much slower and kills the cells during the analysis. Flow cytometry keeps the cells alive and thereby making it possible to sort the cells for additional assays.

While flow cytometry also uses antibodies that bind to different markers, CyTOF differs in that the antibodies are tagged with heavy metal atoms that are usually not found in living cells, rather than with fluorescent markers. The labeled cells are then analyzed by mass spectrometry, which can differentiate more markers at the same time than flow cytometry because their signals overlap less than fluorescent signals.

Evan Newell and colleagues at Stanford University analyzed CD8+ T cells from 6 healthy people for 16 cell surface markers, 9 functional markers such as cytokines, and 6 antigen specificities for three viruses: Epstein-Barr virus (EBV), flu virus, and cytomegalovirus (CMV). The study findings demonstrated that CD8+ T cells exhibit a much greater degree of complexity than was previously appreciated. The highlights of this interesting study include:

· T cell specificity, phenotype, and function can be assessed by mass spectrometry

· Principal component analysis revealed a common pattern of phenotypic progression

· Expression of cytokines by CD8⁺ T cells showed large combinatorial diversity

· Viral-specific cells occupied distinct niches of phenotypic and functional diversity

Image courtesy: ACCN

For more details: Evan W. Newell, Natalia Sigal, Sean C. Bendall, Garry P. Nolan, Mark M. Davis. Cytometry by Time-of-Flight Shows Combinatorial Cytokine Expression and Virus-Specific Cell Niches within a Continuum of CD8⁺ T Cell Phenotypes. Immunity - 2012 (Vol. 36, Issue 1, pp. 142-152)

When to Start? US Panel recommends initiating ART regardless of CD4 counts

noreply@blogger.com (Dr RV) — Tue, 03 Apr 2012 07:17:00 +0000

The US Department of Health and Human Services (DHHS) panel recommends Antiretroviral therapy (ART) for all HIV-infected individuals, in the guidelines updated on 27^th March 2012. The panel strongly recommends initiating ART for the following group of patients, a) pregnant women, and people with b) a history of an AIDS illness, c) HIV-associated nephropathy, and d) hepatitis B virus co-infection. These new recommendations are primarily based on the increasing evidence showing the harmful impact of ongoing HIV replication on AIDS and non-AIDS disease progression and the updated recommendations are also based on the emerging data showing the benefit of ART in preventing secondary transmission of HIV. Recommended first-line regimens remain the same: efavirenz or ritonavir-boosted atazanavir or ritonavir-boosted darunavir or raltegravir, each in combination with tenofovir/emtricitabine.

The experts also recommend that anyone older than 50 years to be initiated on ART, regardless of CD4 count, considering the risk of non-AIDS related complications. However, since antiretroviral side effects occur more often in older people with HIV, the panel advises close monitoring of bone, kidney, metabolic, cardiovascular, and liver health in HIV infected patients of older age.

For further information: HHS Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. 27 March 2012.

Candida - An Emerging Pathogen of Clinical Importance

noreply@blogger.com (Dr RV) — Mon, 02 Apr 2012 16:05:00 +0000

Candida albicans is a popularly known fungal organism that can cause several infections in humans. Candida colonizes the mucosal surfaces of all humans soon after birth and the risk of endogenous infection is ever-present. Carriage rate of candida spp. tends to increase with age C.albicans continues to be important commensal and a constituent of the normal gut flora comprising microorganisms that live in the human mouth and gastrointestinal tract. C. albicans lives in 80% of the human population without causing harmful effects, although overgrowth of the fungus results in candidiasis. It can manifest in pathogenic state causing painful mucosal Infections presenting as oral thrush, and vaginal infections, among many other clinical manifestations. One of the primary causes of Candidiasis is the overuse and inappropriate use of antibiotics, steroids, birth control pills, anticancer drugs and several other drugs. To acknowledge Candidiasis as a disease is to acknowledge a problem often caused by drugs! On few occasions Candidiasis predisposes to life threatening systemic infections. The relation of humans to Candida is a dynamic process can change their status from commensals to an opportunistic state, Most of the time, Candida infections of the mouth, skin, or vagina occur for no defined reason. A common cause of infection may be the immunosuppressive conditions, use of antibiotics that destroy beneficial, as well as harmful, microorganisms in the body, permitting candida to multiply in their place. The resulting condition is known as candidiasis.

Candidiasis is emerging problem

With the increase in the prevalence of immunosuppressed patients during the last few decades, as a result of chemotherapy or disease with AIDS which led to a parallel increase in the incidence of Candida infection in general and the less pathogenic non candida albicans spp. in particular. Candida spp. are the fifth most common cause of blood stream infections and fourth common cause of nosocomial infections.

An interesting feature of C. albicans is its ability in growing two different ways; reproduction by budding, forming an ellipsoid bud, and in hyphal forms, which can periodically fragment and give rise to new mycelia, or yeast-like forms. Transitions between the two phenotypes can be induced in vitro in response to several environmental cues such as pH or temperature, or different media. Like other pathogenic fungi, C. albicans exhibits a number of different morphological forms under different environmental conditions; such forms include budding yeast cells (blastospores, blastoconidia), pseudo hyphae (elongated cells which appear as filamentous cell chains), true hyphae, and clamydospores.

Microbiology of Candida spp

Candida albicans historically has been documented as the predominant cause of Candidiasis There are several species among the Candida, few have higher predisposition in causing Candidiasis. The genus Candida includes around 154 species. Among these, six are most frequently isolated in human infections. While Candida albicans is the most abundant and significant species, Candida tropicalis, Candida glabrata, Candida parapsilosis, Candida krusei, and Candida lusitaniae are also isolated as causative agents of Candidal infections. Importantly, there has been a recent increase in infections due to non-albicans Candida spp., such as Candida glabrata and Candida krusei. Patients receiving fluconazole prophylaxis are particularly at risk of developing infections due to fluconazole-resistant Candida krusei and Candida glabrata strains. Nevertheless, the diversity of Candida spp. that are encountered in infections is expanding and the emergence of other species that were rarely in causing diseases in the past is now likely which include, C glabrata Candida parapsilosis, Candida krusei . However majority of isolates are still C.albicans and account for 85 – 95% of infections. Many studies prove C.glabrata can cause 10 -20 % of the infections. The importance of speciation is gaining importance as several anti-candida drugs are becoming drug resistant due to over the counter availability, failure to administer the optimal dosage and lead to recurrent infections. Future demands will rise for identification of species and antifungal sensitivity

Why Specific diagnosis of Candida Infection still difficult

Clinical manifestations of candidiasis are extremely varied, ranging from acute, sub-acute, chronic and episodic. Involvement may be localized to the mouth, throat, skin, scalp, vagina, fingers, toes shown to the left), nails, bronchi, lungs or gastrointestinal tract. It may also be systemic as in septicaemia (circulating in the blood and causing damage to blood vessels and sometimes blood cells), endocarditis and meningitis. Pathologic processes evoked are diverse and vary from irritation and inflammation to chronic and acute suppuration or granulomatous response

Invasive fungal disease occurs in at-risk patient population

· Immunocompromised patients

· Patients on immunomodulatory therapy

· Patients with indwelling devices

· Critically ill patients

· Manifestations of infection may occur in one or more body sites

Candidiasis: Why the Elusive Diagnosis

The diagnosis of Candidiasis is often overlooked in conventional medicine. Many doctors “give less importance to Candidiasis,” even though there is ample scientific evidence to document the condition. It is difficult to say exactly why this condition is ignored by conventional medicine in spite of the vast scientific evidence? As the symptoms of Candidiasis are widespread and can mimic many other diseases. There is no definitive lab test that confirms the disease, this makes correct diagnosis difficult.

Clinical Diagnosis can be attempted with several specimens

1. Clinical Material: Skin and nail scrapings; urine, sputum and bronchial washings; cerebrospinal fluid, pleural fluid and blood; tissue biopsies from various visceral organs and indwelling catheter tips.

2. It is important to identify the species as less known Candida too are responsible for Candidiasis

As PCR is expensive and not available at all places, speciation of candida can be done by using Chrome agars for candida species differentiation and Carbohydrate assimilation patterns with readily available diagnostic reagents.

3 Testing isolates for Antifungal sensitivity patterns

It is now possible for the clinical microbiology laboratory to perform reliable in vitro antifungal susceptibility tests on a wide range of yeasts and moulds

Development of standardized antifungal susceptibility testing methods has been the focus of intensive research in the last 15 years. Antifungal sensitivity tests can be done with Disk diffusion with simple techniques or by E-test and by broth micro dilution method. E-test is preferred as it gives better sensitivity results on Candida species than dermatophytes for all drugs expect Itraconazole.

Disk diffusion with standard protocols

Can be done in laboratories with few facilities it recommends the use of Mueller-Hinton agar supplemented with 2% glucose and 0.5 ug/ml methylene blue dye medium. Mueller-Hinton agar is readily available and shows acceptable batch-to-batch reproducibility, the glucose provides a suitable growth for most yeasts and the addition of methylene blue enhances the zone edge definition. The pH of the medium needs to be adjusted between 7.2 and 7.4 at room temperature after gelling. The inoculum is standardized to 0.5 McFarland using a densitometer and plates should be incubated at 35 ͦ C for 24 hours. Some strains where insufficient growth has occurred after 24 hours may need to be read after 48 hours incubation. Commercially prepared paper disks for fluconazole (25 µg) and voriconazole (1 µg) are available from Oxoid and Becton Dickinson, and indigenously available from Hi-media in India. The laboratories should use Hi-comb (MIC) method available from Hi-media for doing determining the Minimum inhibitory concentration to commonly used antifungal drugs.

All the newly established laboratories are at a beginning stage in the development of in vitro antifungal susceptibility testing systems. However many issues remain. It goes without saying that you need a culture, which is not always possible. The identity of the culture is often predictive of its in vitro susceptibility, so which isolates should be tested? Only those clinically warranted or should the laboratory screen all isolates? However it needs more wisdom to do or not and too report an isolate a commensal or pathogen.

Needs just not knowledge but good wisdom.

Guest post by : T.V.Rao*. Deepa Babin

The author can be reached at doctortvrao@gmail.com

Need for WHONET Documentation

noreply@blogger.com (Dr RV) — Sun, 01 Apr 2012 13:56:00 +0000

Antibiotics are considered as one of the strengths of modern Medicine, and have helped the humans to progress to the present stage, along with several other advances in Medicine. At present, the antibiotics are used for needy patients and are misused too when there is no need for an antibiotic prescription. Drug resistance develops naturally, but careless practices in drug supply and use are hastening it unnecessarily, we certainly need a system to document the results of antibiotic sensitivity and resistance patterns arising in our Institution, which can be documented with WHONET.

WHONET is free Windows-based database software developed for the management and analysis of microbiology laboratory data with a special focus on the analysis of antimicrobial susceptibility test results. These tools enable microbiology laboratory to put its test results into a database and conduct analysis to support local infection control and antibiotic usage at our hospital.

The software has been developed since 1989 by the WHO Collaborating Centre for Surveillance of Antimicrobial Resistance based at the Brigham and Women's Hospital in Boston, and is used by clinical, public health, veterinary, and food laboratories in over 90 countries to support local and national surveillance programs. Laboratories can also upload files created by WHONET, to feed into national or other multi-centre surveillance networks and to strengthen our Drug policy. Such surveillance programs are now in place in many countries and part of accreditation standards in India.

How we can Progress with WHONET?

We can enhance the local data for local needs: clinical decision support, antimicrobial use policy, infection control and outbreak detection, identifying laboratory test performance, and characterization of local microbial and resistance epidemiology and to promote local, national, regional, and global collaborations through the exchange of data and sharing of experiences.

The WHONET experience suggests that pattern of drug resistance data can be collected and analysed in resource-constrained settings, using core microbiology, if local laboratories are given appropriate support. Strengthening these laboratories is therefore a potentially cost-effective contribution to both treating drug resistant disease and preventing its further spread. Microbiologists, clinicians and infection control workers may use this software to enhance monitoring of drug resistance in their hospitals and communities and to merge their files into national, regional, and global networks for surveillance of drug resistance. WHONET can also analyse stored data. From a single screen, a WHONET user selects the type of analysis to run, the species of bacteria to analyse, the subsets of isolates to include (e.g., all, isolates from urine, blood , and isolates resistant to Cephalosporin’s, Carbapenems or any other drug individually and from certain locations in outpatients and any wards like ICCU’s medicine, surgery or any other speciality).

Every patient in our hospital or its community carries a complex bacterial ecosystem and each patient care unit within the centre and ultimately the centre itself may be seen as an aggregated ecosystem. Resistance genes and the strains they make resistant move through these systems, selectively accelerated by specific antimicrobial agents given to specific patients and retarded by infection control practices. Both strategic and day-to-day management of those practices and the selection of those agents need optimal, current information about the linkages of the resistance genes and the deployment of the strains. The Microbiology laboratory at the hospitals also needs continuing analysis of its susceptibility test and quality control results. Each laboratory tests hundreds of different combinations of bacterial species and antimicrobial agents. Variations in the usual distributions of measurements for any of the combinations, and particularly of those that impinge upon breakpoints may signal either problems in test performance or new types of resistance.

Thus, WHONET helps our hospital:

Creates profile of the Bacterial Infections at our Hospital.
Helps to know the Antibiograms pattern of the different isolates.
Observe trends in MRSA, and patterns of drug resistance in several GNB strains.
Alert the physicians on uncommon, clinically important bacterial pathogens.
Helps faculty to present data at academic associations and in publishing papers as per editorial guidelines.

However it needs greater cooperation of all clinicians to build the system to our hospital needs, and the protocols can be integrated into the antibiotic policy.

Image courtesy: www.whonet.org

Guest Post authored by:

*T.V.Rao, C.Aher, Deepa Babin, Deepthy Sooryadas

Department of Microbiology Travancore Medical College

Kollam, Kerala, India.

The author can be reached at doctortvrao@gmail.com

A big step forward for HCV Vaccinology

noreply@blogger.com (Dr RV) — Mon, 26 Mar 2012 06:58:00 +0000

Hepatitis C virus being more virulent than HIV, coming up with a vaccine against it, that would neutralize different strains around the world remained a challenge. Research team at the university of Alberta, led by Michael Houghton has developed a vaccine for hepatitis C that will potentially help combat HCV infection. Michael Houghton, who led the team that discovered the hepatitis C virus in 1989, announced his recent finding that the vaccine developed has been shown to be effective against all known strains of the virus. Currently there are no vaccines against the disease available and with hundreds of thousands of people being infected with hepatitis C annually, and with between 20 to 30 per cent of those developing some form liver disease, this big step towards a vaccine sounds encouraging. Further studies and testing are required before the vaccine is approved and it is promising that in future it might play a crucial role as a preventative measure against acquiring HCV infection.

Image:Hepatitis C researcher John Law

http://www.news.ualberta.ca/article.aspx?id=B04932D68EF6488A8DE62A463FFA7487

Infection Prevention & Control - Henry the Hand

noreply@blogger.com (Nagarajan Abimanyu) — Mon, 26 Mar 2012 06:08:00 +0000

Henry the hand - An initiative with a vision to simply to improve health by making us more aware of the role our hands play in the spread of disease -“Hand Awareness”

The 4 Principles of Hand Awareness

1. Wash your hands when they are dirty and BEFORE eating
2. DO NOT cough into your hands
3. DO NOT sneeze into your hands
4. Above all, DO NOT put your fingers into your eyes, nose or mouth

For more Information on HAND WASHING AND INFECTION CONTROL, click here.