Publications by authors named "Neelam Gulati"

15 Publications

  • Page 1 of 1

Aspergillus candidus eumycetoma with review of literature.

J Mycol Med 2021 Apr 3;31(3):101135. Epub 2021 Apr 3.

Department of Microbiology, Government Medical College Hospital, Sector 32-B, Chandigarh, India.

Objective: Mycetoma is a slowly progressive, chronic granulomatous infection of skin and subcutaneous tissues with involvement of underlying fasciae and bones, usually affecting extremities. In India, among mycetoma, the eumycetoma constitutes about 35% of cases. Hereby, we report the first case of eumycetoma caused by uncommon fungus, Aspergillus candidus.

Case Report: A 61 year old female presented to the Department of Dermatology with history of swelling of right foot associated with multiple firm nodules of approx. 1.5 × 1.5 cm each over dorsum of foot with discharging sinus containing white color granules. Biopsy of lesion on right foot on direct KOH examination revealed septate hyphae. Histopathology examination showed a histiocytic granuloma with fungal elements. Culture on Sabouraud Dextrose Agar grew white mycelial colonies which were identified to be Aspergillus species phenotypically. Genetic sequencing using Internal transcribed spacer gene, beta tubulin gene and Calmodulin gene was done and the isolate was identified to be Aspergillus candidus. Lesion was excised and patient was started on itraconazole.

Conclusion: Timely identification and starting of antifungal treatment can help in reducing morbidity due to eumycetoma to a large extent. As newer and newer species of fungi are emerging as significant causative agents of human infections, it is pertinent to report such findings from epidemiological point of view.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.mycmed.2021.101135DOI Listing
April 2021

Nocardia Infections: Ten Years Experience from a Tertiary Health Care Center in North India (2007-2016).

Infect Disord Drug Targets 2021 ;21(3):445-451

Department of Microbiology, Government Medical College Hospital, Sector 32, Chandigarh, India.

Background: Nocardia species are important cause of infections in humans but are underreported due to missed diagnosis as well as misdiagnosis. Majority of the literature on these infections consists of case reports or series with few articles describing high number of cases.

Objective: To study the epidemiology of Nocardia infections in a tertiary care center.

Materials And Methods: This retrospective observational study was done in a tertiary care centre of North India over a period of 10 years (2007-2016). The detection of Nocardia spp. from clinical specimens was done by conventional methods viz. direct microscopy (Gram's stain, modified Ziehl -Neelsen stain [1%], KOH examination) and culture.

Results: A total of 25 cases of nocardiosis were diagnosed during the study period. The mean age of the patients was 50.9 years (range 30-72 years) with a male:female ratio of 3:2. The site of disease in these patients included pulmonary (n=18), cutaneous (n=4), perinephric abscess (n=1), ocular (n=1) and bone (n=1). Risk factors associated were underlying lung disease (n=11), smoking (n=7), diabetes (n=5) and steroid therapy (n=4) in pulmonary nocardiosis, iatrogenic (n=1) and leprosy (n=1) in cutaneous nocardiosis, diabetes in perinephric abscess and cataract surgery in ocular nocardiosis. Culture was positive in 12/25 (48%) patients for Nocardia spp. Direct microscopy was positive in 22 patients. We wish to highlight that meticulous observation of KOH wet mount examination helped in clinching the diagnosis of Nocardiosis in 3 cases which were earlier missed by other methods.

Conclusion: Good communication with the clinician alongside a meticulous effort in the laboratory is essential for appropriate diagnosis and management of these cases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2174/1871526520666200516161940DOI Listing
January 2021

Linezolid Resistance in Staphylococcus haemolyticus - Case Series and Review of Literature.

Infect Disord Drug Targets 2020 ;20(5):713-717

Govt. Medical College and Hospital Microbiology, Chandigarh, India.

Background: Coagulase negative Staphylococci (CoNS) are important. The common antibiotics used for the treatment of the infections caused by CoNS are penicillin, oxacillin, ciprofloxacin, clindamycin, erythromycin, gentamicin, and vancomycin. Linezolid is an oxazolidinone group of antibiotic with activity against Gram-positive bacteria. It is used for the treatment of serious infections caused by Gram-positive bacteria resistant to other antibiotics, including streptococci, vancomycin-resistant enterococci (VRE).

Aims And Objective: This study emphasizes on the judicious use of newer antibiotics to contain the spread of resistance.

Method: We are discussing five cases of Linezolid resistant Staphylococcus Haemolyticus which were reported in our laboratory during one year from patients with device related infections and also review of literature is being presented for an update.

Result: In our study, the isolates were resistant to other groups of antimicrobials but susceptible to glycopeptides. All the isolates were methicillin-resistant.

Conclusion: Linezolid is approved as an alternative drug to be given for catheter-related bloodstream infections. In earlier studies, linezolid-resistant staphylococci have been reported increasingly all over the world. This study is to create awareness amongst clinicians that improper and excessive use of linezolid will make this antibiotic-resistant and thus will be of no help in future, so judicious and relevant use of antibiotics needs to be emphasized.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2174/1871526519666190807152850DOI Listing
May 2021

Biofilms: Fungal perspective.

Indian J Pathol Microbiol 2019 Jul-Sep;62(3):514-515

Department of Microbiology, Government Medical College Hospital, Chandigarh, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/IJPM.IJPM_20_18DOI Listing
December 2019

Assessment of tumor growth in pancreatic neuroendocrine tumors in von Hippel Lindau syndrome.

J Am Coll Surg 2014 Feb 12;218(2):163-9. Epub 2013 Nov 12.

Endocrine Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD. Electronic address:

Background: The incidence of pancreatic neuroendocrine tumors (PNETs) is increasing, but only a subset of these heterogeneous tumors will progress to malignant disease, which is associated with a poor prognosis. Currently, there are limited data on the natural history of these tumors and it is difficult to determine which patients require surgical intervention because the risk of metastatic disease cannot be accurately determined.

Study Design: We conducted a prospective study of 87 patients with von Hippel Lindau syndrome-associated solid pancreatic lesions to determine the natural history of these tumors with biochemical testing, follow-up anatomic and functional imaging, and advanced imaging analysis, with a median follow-up of 4 years.

Results: Approximately 20% of consecutive tumor measurements during follow-up were decreased in size and 20% showed no change. This included 2 of 4 surgically proven malignant tumors, which had a net decrease in tumor size over time. Tumor volume, as derived from greatest diameter and volumetric measurements, showed good correlation to pathology tumor measurement of surgically resected tumors (Spearman rank correlation ρ = 0.72, p = 0.0011, and ρ = 0.83, p < 0.0001, respectively). Tumor density measurement had an inverse relationship with tumor size (Spearman rank correlation -0.22, p = 0.0047). A tumor density cutoff of 200 was 75% specific for malignant tumors.

Conclusions: Pancreatic neuroendocrine tumors demonstrate a nonlinear growth pattern, which includes periods of no growth and apparent decrease in size by imaging. These growth patterns are variable and are not associated with tumor grade and malignancy. Tumor density, as measured in this cohort, may offer a specific diagnostic tool for malignant disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jamcollsurg.2013.10.025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3896892PMC
February 2014

MiR-34a and miR-483-5p are candidate serum biomarkers for adrenocortical tumors.

Surgery 2013 Dec;154(6):1224-8; discussion 1229

Endocrine Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD. Electronic address:

Background: Nonfunctioning adrenal incidentalomas are common and many patients undergo adrenalectomy to exclude adrenocortical carcinoma (ACC). Recent studies have shown dysregulated microRNA (miRNA) expression in ACC. The objective of this study was to determine the feasibility and diagnostic accuracy of measuring serum miRNAs in patients with benign and malignant adrenocortical neoplasms.

Method: Five miRNAs were selected from miRNA profiling studies in ACC (miR-let-7d, -34a, -195, -214, and 483-5p). Total miRNA was extracted from serum samples in patients with malignant and benign adrenal neoplasms. miRNAs levels were measured by quantitative reverse transcript polymerase chain reaction and normalized to miR-16. To determine if miRNAs were secreted from ACC cells, we measured miRNA levels in culture.

Results: Serum samples from 22 patients with cortical adenomas and 17 patients with ACC were analyzed, and all 5 miRNAs were detected. We found greater levels of miR-34a (P = .001) and miR-483-5p (P = .011) in patients with ACC. The area under the receiver operating characteristic curve was 0.81 for miR-34a and 0.74 for miR-438-5p. MiR-34a and miR-483-5p levels in ACC cells were greater in the supernatant at 48 hours compared with intracellular levels.

Conclusion: We show that dysregulated miRNAs in ACC are detectable in human serum samples. MiR-34a and miR-483-5p are candidate serum biomarkers for distinguishing between benign and malignant adrenocortical tumors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.surg.2013.06.022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874721PMC
December 2013

Prospective screening in familial nonmedullary thyroid cancer.

Surgery 2013 Dec 23;154(6):1194-8. Epub 2013 Aug 23.

Endocrine Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD. Electronic address:

Background: Approximately 8% of nonmedullary thyroid cancers are familial. The optimal age for screening in familial nonmedullary thyroid cancer (FNMTC) is unknown.

Methods: Kindreds with FNMTC (2 or more first-degree relatives affected) were screened prospectively with thyroid ultrasonography.

Results: Fifteen kindreds showed an overall prevalence of thyroid nodule(s) ≥5 mm of 44% at screening; 19% in the second generation, and 90% in the generation anterior to the index case. The youngest age of detection was 10 years for thyroid nodules and 18 years for thyroid cancer. Microcalcification of thyroid nodules at screening was associated with a greater risk of cancer (P < .05). Family members diagnosed with thyroid cancer by ultrasonographic screening were diagnosed at a younger age and had a lower rate of extra thyroidal invasion (P < .05).

Conclusion: In FNMTC, first-degree relatives 10 years or older, including the generation anterior to the index case, should have thyroid screening by ultrasonography, which may result in earlier diagnosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.surg.2013.06.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857607PMC
December 2013

Telomere length is shorter in affected members of families with familial nonmedullary thyroid cancer.

Thyroid 2013 Mar;23(3):301-7

Endocrine Oncology Branch, National Cancer Institute, Bethesda, Maryland 20892, USA.

Background: The theory that short telomere length and genetic defects in maintaining telomere length are associated with familial nonmedullary thyroid cancer (FNMTC) is controversial. Thus, the aim of this study was to determine whether telomere length and genes involved in maintaining telomere length are altered in FNMTC.

Methods: Blood samples were collected from 44 members (13 affected and 31 unaffected) of six families with FNMTC and from 60 controls. Quantitative polymerase chain reaction (Q-PCR) and reverse transcription PCR were performed to analyze relative telomere length (RTL), gene copy number, and mRNA expression of telomerase reverse transcriptase (hTERT), telomere repeat binding factor 1 (TRF1), telomere repeat binding factor 2 (TRF2), repressor activator protein 1 (RAP1), TRF1 interacting nuclear factor 2 (TIN2), tripeptidyl peptidase 1 (TPP1), and protection of telomere 1 (POT1).

Results: Affected members had shorter RTL, as compared with unaffected members (0.98 vs. 1.23, p<0.01). There was no significant difference in hTERT, TRF1, TRF2, RAP1, TIN2, TPP1, and POT1 gene copy number or mRNA expression between affected and unaffected members.

Conclusions: RTL is shorter in affected members with FNMTC but is not associated with altered copy number or expression in hTERT, TRF1, TRF2, RAP1, TIN2, TPP1, and POT1. The small differences in RTL preclude the utility of RTL as a marker for FNMTC in at-risk individuals.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1089/thy.2012.0270DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3593684PMC
March 2013

AmpC β-lactamases in nosocomial isolates of Klebsiella pneumoniae from India.

Indian J Med Res 2012 Aug;136(2):237-41

Department of Microbiology, Government Medical College & Hospital, Chandigarh, India.

Background & Objectives: AmpC β-lactamases are clinically significant since these confer resistance to cephalosporins in the oxyimino group, 7-α methoxycephalosporins and are not affected by available β-lactamase inhibitors. In this study we looked for both extended spectrum β-lactamases (ESBL) and AmpC β-lactamases in Klebsiella pneumoniae clinical isolates.

Methods: One hundred consecutive, non-duplicate clinical isolates of K. pneumoniae collected over a period of one year (June 2008 - June 2009) were included in the study. An antibiotic susceptibility method was used with 10 antibiotics for Gram-negative infections which helped in screening for ESBL and AmpC β-lactamases and also in confirmation of ESBL production. The detection of AmpC β-lactamases was done based on screening and confirmatory tests. For screening, disc diffusion zones of cefoxitin <18 mm was taken as cefoxitin resistant. All cefoxitin resistant isolates were tested further by AmpC disk test and modified three dimensional test. Multiplex-PCR was performed for screening the presence of plasmid-mediated AmpC genes.

Results: Of the 100 isolates of K. pneumoniae studied, 48 were resistant to cefoxitin on screening. AmpC disk test was positive in 32 (32%) isolates. This was also confirmed with modified three dimensional test. Indentation indicating strong AmpC producer was observed in 25 isolates whereas little distortion (weak AmpC) was observed in 7 isolates. ESBL detection was confirmed by a modification of double disk synergy test in 56 isolates. Cefepime was the best cephalosporin in synergy with tazobactam for detecting ESBL production in isolates co-producing AmpC β-lactamases. The subsets of isolates phenotypically AmpC β-lactamase positive were subjected to amplification of six different families of AmpC gene using multiplex PCR. The sequence analysis revealed 12 CMY-2 and eight DHA-1 types.

Interpretation & Conclusions: Tazobactam was the best β-lactamase inhibitor for detecting ESBL in presence of AmpC β-lactamase as this is a very poor inducer of AmpC gene. Amongst cephalosporins, cefepime was the best cephalosporin in detecting ESBL in presence of AmpC β-lactamase as it is least hydrolyzed by AmpC enzymes. Cefepime-tazobactam combination disk test would be a simple and best method in detection of ESBLs in Enterobacteriaceae co-producing AmpC β-lactamase in the routine diagnostic microbiology laboratories.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3461735PMC
August 2012

Candida colonization in urine samples of ICU patients: determination of etiology, antifungal susceptibility testing and evaluation of associated risk factors.

Mycopathologia 2012 Aug 22;174(2):149-55. Epub 2012 Jun 22.

Department of Microbiology, Government Medical College Hospital, Chandigarh, India.

The presence of Candida in urine presents a therapeutic challenge for the physician as it is often asymptomatic, and management guidelines have not been clearly laid down on this issue. The presence of Candida in urine may represent contamination of clinical sample, actual colonization of the lower urinary tract or may be a true indicator of invasive infection of lower and/or upper urinary tract. In a clinical setting like the ICU, multiple risk factors for Candida colonization may be present in the same patient, thereby increasing the chances of candiduria, manifold. In the present study on 80 patients in ICU, high rate of Candida colonization (57.5%) was found in urine samples of ICU patients with C. tropicalis (57.3%) being the predominant species. We also isolated 8 strains of Trichosporon species, all of these presented as a mixed infection along with Candida species. Among the various risk factors studied, urinary catheterization and previous antibiotic therapy were identified as statistically significant (P value <0.05). The minimum inhibitory concentration of the isolates was determined for amphotericin B, fluconazole and itraconazole by E-test. Most of the isolates were susceptible to amphotericin B. The C. parapsilosis strains did not show any drug resistance; however, resistance to fluconazole was observed 18.6, 27.27, 50 and 25% in C. tropicalis, C. albicans, C. glabrata and Trichosporon species, respectively.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11046-011-9514-7DOI Listing
August 2012

Evaluation of various methods for the detection of meticillin-resistant Staphylococcus aureus strains and susceptibility patterns.

J Med Microbiol 2011 Nov 21;60(Pt 11):1613-1616. Epub 2011 Jul 21.

Department of Microbiology, Government Medical College Hospital, Chandigarh, India.

Meticillin-resistant Staphylococcus aureus (MRSA) has been recognized as one of the major pathogens in hospital as well as community settings. In India, the mean isolation rate of MRSA is 20-40 % and many studies have suggested an escalating rate of infections caused by this organism. Despite pharmaceutical and technological advancement, infections caused by MRSA still remain difficult to diagnose. The present study was undertaken to compare five phenotypic methods for the detection of MRSA. This involved examining 200 isolates of S. aureus by oxacillin disc diffusion, cefoxitin disc diffusion, oxacillin screen agar test, the latex agglutination test and growth on CHROMagar. PCR for mecA gene detection was taken as the gold standard. It was found that 35 % of all S. aureus infections were caused by MRSA. The cefoxitin disc diffusion method, as recommended by the Clinical and Laboratory Standards Institute, was found to be a reliable method for MRSA detection but it should be supplemented with some other method like latex agglutination, CHROMagar or oxacillin screen agar testing so that no MRSA is missed. We recommend that along with cefoxitin disc diffusion, another method, preferably latex agglutination, should be routinely used in all hospitals to detect MRSA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1099/jmm.0.032219-0DOI Listing
November 2011

Morganella morganii could be an important Intensive Care Unit pathogen.

Indian J Crit Care Med 2010 Jul;14(3):154-5

Department of Microbiology, Government Medical College Hospital, Chandigarh, (India).

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0972-5229.74176DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021833PMC
July 2010

Fusarium sacchari: a cause of exogenous fungal endophthalmitis: first case report and review of literature.

Mycopathologia 2011 Jun 24;171(6):431-4. Epub 2010 Oct 24.

Department of Microbiology, Government Medical College Hospital, Sector 32, Chandigarh 160030, India.

A case of exogenous fungal endophthalmitis due to Fusarium sacchari is being reported. It has never been reported in this clinical entity before; hence, to the best of our knowledge, this is first report of F. sacchari as a cause of exogenous fungal endophthalmitis and also the first time when this fungus has been isolated from an Indian patient.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11046-010-9374-6DOI Listing
June 2011

Drug resistant urinary isolates of pseudomonas aeruginosa and acinetobacter species.

J Glob Infect Dis 2010 Sep;2(3):315-7

Department of Microbiology, Dr. H. S. J. Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0974-777X.68547DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946696PMC
September 2010