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Muralidhar S.,Training and Research Center
Indian Journal of Sexually Transmitted Diseases | Year: 2015

Sexually transmitted infections (STIs) are a public health problem, and their prevalence is rising even in developed nations, in the era of HIV/AIDS. While the consequences of STIs can be serious, the good news is that many of these complications are preventable if appropriate screening is done in high-risk individuals, when infection is strongly suspected. The diagnostic tests for STIs serve many purposes. Apart from aiding in the diagnosis of typical cases, they help diagnose atypical cases, asymptomatic infections and also multiple infections. But, the test methods used must fulfill the criteria of accuracy, affordability, accessibility, efficiency, sensitivity, specificity and ease of handling. The results must be rapid, cost-effective and reliable. Most importantly, they have to be less dependent on collection techniques. The existing diagnostic methods for STIs are fraught with several challenges, including delay in results, lack of sensitivity and specificity. With the rise of the machines in diagnostic microbiology, molecular methods offer increased sensitivity, specificity and speed. They are especially useful for microorganisms that cannot be, or are difficult to cultivate. With the newer diagnostic technologies, we are on the verge of a major change in the approach to STI control. When diagnostic methods are faster and results more accurate, they are bound to improve patient care. As automation and standardization increase and human error decreases, more laboratories will adopt molecular testing methods. An overview of these methods is given here, including a note on the point-of-care tests and their usefulness in the era of rapid diagnostic tests. Source

Kulkarni S.,National Dairy Research Institute | Bala M.,Training and Research Center | Risbud A.,National Dairy Research Institute
Sexually Transmitted Diseases | Year: 2012

Sixty-four Neisseria gonorrhoeae strains isolated from patients attending sexually transmitted disease clinics at Pune and Delhi between January 2007 and June 2008, were subjected to antimicrobial susceptibility testing, auxotyping, and serotyping. We observed 6 antibiotic resistance patterns, 6 auxotypes, 3 serogroups, and 17 serovars. The combination of auxotyping and serotyping is a potential useful method for typing N. gonorrhoeae as a result of high discriminatory index, rapidity, ease, and relatively lower cost. © 2012 American Sexually Transmitted Diseases Association All rights reserved. Source

The burden of "multidrug-resistant Neisseria gonorrhoeae" (MDR-NG) was high considering the old definition (26.0%). According to the new definitions, no strain was MDR or extensively drug-resistant. The emergence of resistance to ceftriaxone and cefixime will lead to detection of MDR-NG and may be extensively drug-resistant NG, even according to the new definition. © 2011 American Sexually Transmitted Diseases Association All rights reserved. Source

Sethi S.,Post Graduate Institute of Medical Education and Research | Golparian D.,Orebro University | Bala M.,Training and Research Center | Dorji D.,JDW NR Hospital | And 3 more authors.
BMC Infectious Diseases | Year: 2013

Background: Knowledge on antimicrobial drug resistance and genetic characteristics of Neisseria gonorrhoeae isolates circulating in India, Pakistan, and Bhutan is sorely lacking. In this paper, we describe the prevalence of antimicrobial resistance and molecular characteristics of N. gonorrhoeae isolates from India, Pakistan, and Bhutan in 2007-2011.Methods: Antimicrobial susceptibility and β-lactamase production were tested for 65 N. gonorrhoeae isolates from India (n=40), Pakistan (n=18) and Bhutan (n=7) using Etest methodology (eight antimicrobials) and nitrocefin solution, respectively. Resistance determinants, i.e. penA, mtrR, porB1b, gyrA, and parC, were sequenced. N. gonorrhoeae multiantigen sequence typing (NG-MAST) was performed for molecular epidemiology.Results: The highest resistance level was observed for ciprofloxacin (94%), followed by penicillin G (68%), erythromycin (62%), tetracycline (55%), and azithromycin (7.7%). All the isolates were susceptible to ceftriaxone, cefixime, and spectinomycin. Thirty-four (52%) of the isolates were producing β-lactamase. No penA mosaic alleles or A501-altered alleles of penicillin-binding protein 2 were identified. Forty-nine NG-MAST STs were identified, of which 42 STs have not been previously described worldwide.Conclusions: Based on this study, ceftriaxone, cefixime, and spectinomycin can be used as an empirical first-line therapy for gonorrhoea in India, Pakistan, and Bhutan, whereas ciprofloxacin, penicillin G, tetracycline, erythromycin, and azithromycin should not be. It is imperative to strengthen the laboratory infrastructure in this region, as well as to expand the phenotypic and genetic surveillance of antimicrobial resistance, emergence of new resistance, particularly, to extended-spectrum cephalosporins, and molecular epidemiology. © 2013 Sethi et al.; licensee BioMed Central Ltd. Source

Sharma C.,University of Delhi | Muralidhar S.,Training and Research Center | Xu J.,McMaster University | Meis J.F.,Radboud University Nijmegen | Chowdhary A.,University of Delhi
Mycoses | Year: 2014

We investigated the prevalence of vulvovaginal candidiasis due to C. africana in an STD clinic in India and analysed the genetic relatedness of these C. africana isolates with those outside India. A total of 283 germ-tube-positive yeasts were identified by VITEK2. Molecular characterisation of all isolates was carried out by hwp1-gene-specific PCR. Of 283 germ-tube-positive yeast isolates, four were identified as C. africana using hwp1-gene-specific PCR. All hwp1 PCR positive C. africana were subjected to antifungal susceptibility testing, ITS and D1/D2 region sequencing and were typed by using MLST approach. Similar to C. africana isolates from the United Kingdom and unlike those from Africa, the Indian C. africana grew at 42°C. Sequencing of eight gene fragments in MLST identified all four strains to have different genotypes not reported previously. Furthermore, though the Indian C. africana isolates were susceptible to most of the 14 tested antifungal drugs, differences in susceptibility were observed among the four strains. Our results indicate genetic and phenotypic heterogeneity among C. africana from different geographical regions. Due to lack of data on epidemiology and genetic variability of this under-reported yeast, more studies using molecular methods are warranted. © 2014 Blackwell Verlag GmbH. Source

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