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Article ; Online: Resurgence of diphtheria in rural areas of North Karnataka, India.

Parande, Mahantesh V / Roy, Subarna / Mantur, B G / Parande, Aisha M / Shinde, Rupali S

2017 Volume 35, Issue 2, Page(s) 247–251

Abstract: Background: A diphtheria outbreak was identified from Vijayapura (formerly Bijapur) district in the South Indian state of Karnataka in 2011. There was a surge in the number of throat swab samples received under the Integrated Disease Surveillance ... ...

Abstract	Background: A diphtheria outbreak was identified from Vijayapura (formerly Bijapur) district in the South Indian state of Karnataka in 2011. There was a surge in the number of throat swab samples received under the Integrated Disease Surveillance Programme (IDSP) in North Karnataka since then. Objectives: A microbiological study was undertaken to generate information on the status of resurgence of the disease in the region. Materials and methods: Throat swabs from 432 suspected cases of diphtheria during 2012-2015 were obtained from government hospitals and primary health centres of 8 districts in North Karnataka and were processed for the culture and identification of Corynebacterium diphtheriae. Polymerase chain reaction for the presence of toxin gene (toxA and toxB) was carried out on the isolates. Antibiotic sensitivity tests were performed on the isolates with a panel of 14 antibiotics. Results: Thirty-eight (8.79%) out of 432 samples yielded C. diphtheriae on culture. All isolates possessed the diphtheria toxin gene. Out of the 38 confirmed cases, whereas 21 (55.26%) were between 1 and 5 years of age, 14 (36.84%) were aged between 5 and 10 years. Male children were three times more than females in confirmed cases. No information was available on the immunisation status of the cases. Emergence of resistance to penicillin was found with minimum inhibitory concentration reaching up to 6.00 μg/ml. Conclusion and discussion: Our study identified an upsurge in cases of diphtheria in North Karnataka, particularly in Vijayapura District, and to the best of our knowledge, reports the emergence of penicillin resistance for the first time in India. The study calls for enhanced surveillance for the disease, making antidiphtheritic serum available in key hospitals in the region and serves to provide a baseline for future assessment of the impact of the recently launched 'Mission Indradhanush' programme in strengthening Universal Immunisation Programme (UIP).
Language	English
Publishing date	2017-04
Publishing country	India
Document type	Journal Article
ZDB-ID	1038798-5
ISSN	1998-3646 ; 0255-0857
ISSN (online)	1998-3646
ISSN	0255-0857
DOI	10.4103/ijmm.IJMM_17_48
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Article: Brucellosis in India - a review.

Mantur, Basappa G / Amarnath, Satish K

Journal of biosciences

2009 Volume 33, Issue 4, Page(s) 539–547

Abstract: ... recorded cases globally with cattle emerging as a important reservoir with the few cases of B. suis ...

Abstract	Brucellosis is an important re-emerging zoonosis with a worldwide distribution. It is still an uncontrolled serious public health problem in many developing countries including India. Brucellosis in India is yet a very common but often neglected disease. Currently, Brucella melitensis accounts for most recorded cases globally with cattle emerging as a important reservoir with the few cases of B. suis. Isolated cases of non-terrestrial brucellosis and continuing transmission from wild animals have raised important epidemiological issues. Routine serological surveillance along with high clinical suspicion and screening of family members of index cases would be essential in delineating the real magnitude of human brucellosis in endemic countries. Increased business and leisure travel to endemic countries have led to diagnostic challenge in non-endemic areas. Laboratory testing is indispensable for diagnosis. Advances in newer rapid, sensitive, and specific testing methodologies and alternate treatment strategies are urgently needed. A safe and effective vaccine in human is not yet available. Prevention is dependent upon increasing public awareness through health education programmes and safe livestock practices. Active co-operation between health and veterinary services should be promoted. This review collates world literature and its impact to the discovery, isolation and diagnosis and epidemiology along with the control measures adapted in the Indian scenario.
MeSH term(s)	Animals ; Brucella/genetics ; Brucella/immunology ; Brucellosis/diagnosis ; Brucellosis/epidemiology ; Brucellosis/etiology ; Brucellosis/prevention & control ; Cattle ; Disease Reservoirs ; Humans ; India/epidemiology ; Zoonoses/epidemiology ; Zoonoses/microbiology
Language	English
Publishing date	2009-02-10
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	756157-x
ISSN	0250-5991
ISSN	0250-5991
DOI	10.1007/s12038-008-0072-1
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Article ; Online: Resurgence of diphtheria in rural areas of North Karnataka, India

Mahantesh V Parande / Subarna Roy / B G Mantur / Aisha M Parande / Rupali S Shinde

Indian Journal of Medical Microbiology, Vol 35, Iss 2, Pp 247-

2017 Volume 251

Abstract	Background: A diphtheria outbreak was identified from Vijayapura (formerly Bijapur) district in the South Indian state of Karnataka in 2011. There was a surge in the number of throat swab samples received under the Integrated Disease Surveillance Programme (IDSP) in North Karnataka since then. Objectives: A microbiological study was undertaken to generate information on the status of resurgence of the disease in the region. Materials and Methods: Throat swabs from 432 suspected cases of diphtheria during 2012–2015 were obtained from government hospitals and primary health centres of 8 districts in North Karnataka and were processed for the culture and identification of Corynebacterium diphtheriae. Polymerase chain reaction for the presence of toxin gene (toxA and toxB) was carried out on the isolates. Antibiotic sensitivity tests were performed on the isolates with a panel of 14 antibiotics. Results: Thirty-eight (8.79%) out of 432 samples yielded C. diphtheriae on culture. All isolates possessed the diphtheria toxin gene. Out of the 38 confirmed cases, whereas 21 (55.26%) were between 1 and 5 years of age, 14 (36.84%) were aged between 5 and 10 years. Male children were three times more than females in confirmed cases. No information was available on the immunisation status of the cases. Emergence of resistance to penicillin was found with minimum inhibitory concentration reaching up to 6.00 μg/ml. Conclusion and Discussion: Our study identified an upsurge in cases of diphtheria in North Karnataka, particularly in Vijayapura District, and to the best of our knowledge, reports the emergence of penicillin resistance for the first time in India. The study calls for enhanced surveillance for the disease, making antidiphtheritic serum available in key hospitals in the region and serves to provide a baseline for future assessment of the impact of the recently launched 'Mission Indradhanush' programme in strengthening Universal Immunisation Programme (UIP).
Keywords	Diphtheria ; epidemiology ; immunisation ; outbreak ; Science ; Q ; Microbiology ; QR1-502
Subject code	950
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
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Article ; Online: Draft genome sequence of field isolate Brucella melitensis strain 2007BM/1 from India.

Singh, D K / Kumar, Bablu / Shrinet, Garima / Singh, R P / Das, Aparajita / Mantur, B G / Abhishek / Pandey, Aruna / Mondal, Piyali / Sajjanar, B K / Doimari, Soni / Singh, Vijayata / Kumari, Reena / Tiwari, A K / Gandham, Ravi Kumar

Journal of global antimicrobial resistance

2018 Volume 13, Page(s) 152–153

Abstract: ... for humans. Here we report the draft genome sequence of B. melitensis strain 2007BM/1 isolated from a human ... in highly zoonotic B. melitensis and suggest the need for judicious use of antibiotics in livestock health ...

Abstract	Objectives: Brucellosis is among one of the most widespread important global zoonotic diseases that is endemic in many parts of India. Brucella melitensis is supposed to be the most pathogenic species for humans. Here we report the draft genome sequence of B. melitensis strain 2007BM/1 isolated from a human in India. Methods: Genomic DNA was extracted from Brucella culture and was sequenced using an Illumina MiSeq platform. The generated reads were assembled using three de novo assemblers and the draft genome was annotated. Results: This monoisolate, with a genome length of 3268756bp, was found to be resistant to azithromycin and trimethoprim/sulfamethoxazole but susceptible to tetracycline, ofloxacin, rifampicin, ciprofloxacin and doxycycline. The presence of virulence genes in the strain was identified. Conclusions: The results obtained will help in understanding drug resistance mechanisms and virulence factors in highly zoonotic B. melitensis and suggest the need for judicious use of antibiotics in livestock health and management practices.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Brucella melitensis/drug effects ; Brucella melitensis/genetics ; Brucellosis/microbiology ; Drug Resistance, Multiple, Bacterial ; Genome, Bacterial ; Humans ; India ; Virulence/genetics ; Virulence Factors/genetics
Chemical Substances	Anti-Bacterial Agents ; Virulence Factors
Language	English
Publishing date	2018-04-21
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2710046-7
ISSN	2213-7173 ; 2213-7165
ISSN (online)	2213-7173
ISSN	2213-7165
DOI	10.1016/j.jgar.2018.04.008
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Article: Clinical utility of a quantitative Rose Bengal slide agglutination test in the diagnosis of human brucellosis in an endemic region.

Mantur, Basappa G / Amarnath, Satish K / Patil, Giridhar A / Desai, Arun S

Clinical laboratory

2014 Volume 60, Issue 4, Page(s) 533–541

Abstract: ... as gold standard.: Results: B. melitensis was cultured in only 28% of the patients in this study ...

Abstract	Background: Brucellosis currently ranks as the most important zoonotic disease in the world. Brucellosis is difficult to diagnose because patients often have nonspecific clinical symptoms that can be attributed to a number of disease agents prevalent in the area. Thus, this has necessitated the dependency of clinicians on microbiological confirmation, very often by sero diagnostic methods. Early and accurate detection of brucellosis is important if specific antibiotic treatment is to be effective for the patients. The use of RBST as a qualitative means of diagnosis is quiet common. However, to date, there are only a handful of reports of the application of RBST as a quantitative diagnostic method in medical literature. The potential usefulness of quantitative Rose Bengal slide agglutination test (RBST) for suspected brucellosis was evaluated as a simple, inexpensive diagnostic tool to be used in clinical practice in an endemic region. Methods: 200 consecutive patients who reported to Belgaum Institute of Medical Sciences (BIMS) Hospital, Belgaum, Karnataka (India) between June 2009 and December 2011 were studied. Standard RBST, quantitative RBST, standard tube agglutination test (SAT), 2-mercaptoethanol test (2-ME), and blood cultures were carried out on all patients. The case was confirmed as positive for brucellosis if any one of the tests was positive and the data was compared to the quantitative RBST considering blood culture result as gold standard. Results: B. melitensis was cultured in only 28% of the patients in this study. In patients with negative blood cultures, serology was used for diagnosis. The sensitivities were 88.9% (standard RBST), 92.6% (SAT), and 57.4% (2ME). The specificities were found to be 87.7% (standard RBST), 86.2% (SAT), and 95.7% (2ME). RBST titers > or = 1:8 were detected in a majority of patients (50, 74%) with bacteriologically proven brucellosis thereby guiding clinician for prompt therapy. Prozone reaction with RBST observed in 4 patients was an interesting finding and these four true cases would have been underdiagnosed and denied therapy on the basis of qualitative/standard RBST alone. The possibility of prozone in patient's serum with high RBST antibody titers can be avoided by testing several dilutions. Conclusions: This technique has an immense value particularly for use in resource poor settings seen in rural areas. It can deliver definitive diagnosis in < 10 minutes to the clinician, which may in turn result in the early initiation of specific treatment and could be applied thus as a bedside methodology. It is not technically demanding and easy to interpret, does not involve heavy capital outlay, or trained personnel and, thus, is potentially useful in resource poor laboratories, particularly in developing regions. In addition, quantitative RBST demonstrates sensitivity and specificity equivalent to that achievable by performing SAT. It can readily be extended to screen a vast number of blood samples particularly in areas where brucellosis is hyperendemic. Quantitative RBST and 2ME have been noted to be of great value in therapeutic monitoring. Our data suggest that RBST titers in a range of 1:8 and 1:16 can undoubtedly be considered diagnostic of brucellosis in conjunction with compatible clinical and epidemiological evidence for the patients residing in areas endemic for the disease. Quantitative RBST is, therefore, recommended for routine use in clinical microbiology laboratories as an accurate and speedy diagnostic assay.
MeSH term(s)	Adolescent ; Adult ; Aged ; Agglutination Tests ; Brucellosis/diagnosis ; Brucellosis/epidemiology ; Child ; Child, Preschool ; Endemic Diseases ; Female ; Humans ; India/epidemiology ; Male ; Middle Aged ; Prospective Studies ; Rose Bengal ; Young Adult
Chemical Substances	Rose Bengal (1ZPG1ELY14)
Language	English
Publishing date	2014-04-25
Publishing country	Germany
Document type	Clinical Trial ; Journal Article
ZDB-ID	1307629-2
ISSN	1433-6510 ; 0941-2131
ISSN	1433-6510 ; 0941-2131
DOI	10.7754/clin.lab.2013.121120
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Article ; Online: Splenic Abscess due to Brucella Melitensis - A Rare Pediatric Complication.

Parande, Aisha M / Mantur, B G / Kore, Mahesh / Palled, Eranna

Journal of laboratory physicians

2010 Volume 2, Issue 2, Page(s) 105–108

Abstract: Splenic abscess due to Brucella species is an extremely rare complication especially in acute illness. Here we report a case of splenic abscess caused by Brucella melitensis biotype 1 in a child with acute infection who was successfully treated with only ...

Abstract	Splenic abscess due to Brucella species is an extremely rare complication especially in acute illness. Here we report a case of splenic abscess caused by Brucella melitensis biotype 1 in a child with acute infection who was successfully treated with only antibiotics.
Language	English
Publishing date	2010-11-01
Publishing country	Germany
Document type	Case Reports
ZDB-ID	2461120-7
ISSN	0974-7826 ; 0974-2727
ISSN (online)	0974-7826
ISSN	0974-2727
DOI	10.4103/0974-2727.72212
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Article: Review of clinical and laboratory features of human brucellosis.

Mantur, B G / Amarnath, S K / Shinde, R S

Indian journal of medical microbiology

2007 Volume 25, Issue 3, Page(s) 188–202

Abstract: ... of Brucella melitensis by Sir David Bruce in 1887. Although many countries have eradicated B. abortus from cattle ... in some areas B. melitensis and B. suis have emerged as causes of this infection in cattle, leading to human ... infections. Currently B. melitensis remains the principal cause of human brucellosis worldwide including ...

Abstract	Infection with Brucella spp. continues to pose a human health risk globally despite strides in eradicating the disease from domestic animals. Brucellosis has been an emerging disease since the discovery of Brucella melitensis by Sir David Bruce in 1887. Although many countries have eradicated B. abortus from cattle, in some areas B. melitensis and B. suis have emerged as causes of this infection in cattle, leading to human infections. Currently B. melitensis remains the principal cause of human brucellosis worldwide including India. The recent isolation of distinct strains of Brucella from marine mammals as well as humans is an indicator of an emerging zoonotic disease. Brucellosis in endemic and non-endemic regions remains a diagnostic puzzle due to misleading non-specific manifestations and increasing unusual presentations. Fewer than 10% of human cases of brucellosis may be clinically recognized and treated or reported. Routine serological surveillance is not practiced even in Brucella - endemic countries and we suggest that this should be a part of laboratory testing coupled with a high index of clinical suspicion to improve the level of case detection. The screening of family members of index cases of acute brucellosis in an endemic area should be undertaken to pick up additional unrecognised cases. Rapid and reliable, sensitive and specific, easy to perform and automated detection systems for Brucella spp. are urgently needed to allow early diagnosis and adequate antibiotic therapy in time to decrease morbidity / mortality. The history of travel to endemic countries along with exposure to animals and exotic foods are usually critical to making the clinical diagnosis. Laboratory testing is indispensable for diagnosis. Therefore alertness of clinician and close collaboration with microbiologist are essential even in endemic areas to correctly diagnose and treat this protean human infection. Existing treatment options, largely based on experience gained > 30 years ago, are adequate but not optimal. In our experience, an initial combination therapy with a three drug-regimen followed by a two-drug regimen for at least six weeks and a combination of two drugs with a minimum of six weeks seems warranted to improve outcome in children and adult patients respectively with laboratory monitoring. A safe and effective vaccine in humans is not yet available. Prevention is dependent upon the control of the disease in animal hosts, effective heat treatment of dairy produce and hygienic precautions to prevent occupational exposure. This review compiles the experiences and diagnostic and treatment paradigms currently employed in fighting this disease.
MeSH term(s)	Brucella/drug effects ; Brucella/metabolism ; Brucella/pathogenicity ; Brucellosis/diagnosis ; Brucellosis/drug therapy ; Brucellosis/pathology ; Diagnosis, Differential ; Humans ; Virulence ; Virulence Factors/metabolism
Chemical Substances	Virulence Factors
Language	English
Publishing date	2007-09-14
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	1038798-5
ISSN	1998-3646 ; 0255-0857
ISSN (online)	1998-3646
ISSN	0255-0857
DOI	10.4103/0255-0857.34758
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Article: Seroprevalence of human immunodeficiency virus & hepatitis B virus co-infection in Belgaum, southern India.

Parande, Mahantesh V / Mantur, B G / Parande, Aisha M / Shinde, Rupali S / Roy, Subarna / Jnaneshwar, K B / Chandrashekhar, M R

The Indian journal of medical research

2013 Volume 138, Issue 3, Page(s) 364–365

MeSH term(s)	Adolescent ; Adult ; Child ; Female ; HIV Infections/complications ; HIV Infections/epidemiology ; Hepatitis B/complications ; Hepatitis B/epidemiology ; Humans ; India/epidemiology ; Male ; Middle Aged ; Seroepidemiologic Studies ; Young Adult
Language	English
Publishing date	2013-10-14
Publishing country	India
Document type	Letter
ZDB-ID	390883-5
ISSN	0971-5916 ; 0019-5340
ISSN	0971-5916 ; 0019-5340
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Article ; Online: A Case of Cryptococcal Lymphadenitis in HIV

Rashmi K. Patil / S. Aruna / Kittur S. K. / Mantur B. G.

Journal of Krishna Institute of Medical Sciences University, Vol 03, Iss 02, Pp 122-

A Chance Diagnosis by Fine Needle Aspiration Cytology

2014 Volume 125

Abstract: A 15 years old boy was presented with inguinal lymphadenopathy. The fine needle aspiration of lymph node revealed budding yeast cells and Cryptococcus neoformans was isolated on culture of the aspirate. On further investigations, patient was found to be ... ...

Abstract	A 15 years old boy was presented with inguinal lymphadenopathy. The fine needle aspiration of lymph node revealed budding yeast cells and Cryptococcus neoformans was isolated on culture of the aspirate. On further investigations, patient was found to be Human Immunodeficiency Virus (HIV) positive with low CD4 count of 207cells/μl. Patient showed good response with antifungal and antiretroviral treatment. Cryptococcosis is the most common, life threatening, opportunistic, fungal disease in HIV infected individuals. Lung, meninges and skin involvement have been described. Lymph node involvement in cryptococcosis is considered to be rare. Therefore a prompt diagnosis is mandatory for early initiation of specific treatment. We report here a case of cryptococcosis presenting as inguinal lymphadenopathy and diagnosed on fine needle aspiration cytology.
Keywords	Cryptococcosis ; FNAC ; Human Immunodeficiency Virus ; Lymph node ; Medicine ; R ; Medicine (General) ; R5-920
Language	English
Publishing date	2014-07-01T00:00:00Z
Publisher	Krishna Institute of Medical Sciences University
Document type	Article ; Online
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Article: Twin outbreak of cholera in rural North Karnataka, India.

Dey, Shuchismita / Parande, Mahantesh V / Parande, Aisha M / Lakkannavar, S L / Rathore, Poonam K / Mantur, B G / Kholkute, Sanjiva D / Roy, Subarna

The Indian journal of medical research

2014 Volume 140, Issue 3, Page(s) 420–426

Abstract: Background & objectives: Successive outbreaks of acute watery diarrhoea occurred in Talikoti and Harnal, located in Bijapur District of the southern Indian s0 tate of Karnataka, in July and August 2012, respectively. These outbreaks were investigated to ...

Abstract	Background & objectives: Successive outbreaks of acute watery diarrhoea occurred in Talikoti and Harnal, located in Bijapur District of the southern Indian s0 tate of Karnataka, in July and August 2012, respectively. These outbreaks were investigated to identify the aetiology and epidemiology. Methods: Information was collected from the local population and health centres. Stool and water samples were collected from the admitted patients and their drinking water sources. Standard microbiological and PCR techniques were employed for isolation and characterization of the pathogen. Results: While 101 people (0.38%) were affected in Talikoti, 200 (20.94%) were affected in Harnal which is a small remote village. All age groups were affected but no death occurred. While the outbreak was smaller, longer and apparently spread by person to person contact in Talikoti, it occurred as a single source flash outbreak at Harnal. A single clone of toxigenic Vibrio cholerae O1 Ogawa biotype El Tor was isolated from the two stool samples obtained from Talikoti and subsequently from three of five stool samples obtained from Harnal indicating village to village spread of the aetiological agent. Striking similarity in antibiotic resistance profiles of these isolates with a particular strain isolated from the city of Belgaum, 250 km away, in 2010, prompted tracking the lineage of the V. cholerae isolates by DNA fingerprinting. Random amplified polymorphic DNA (RAPD) fingerprinting assay helped confirm the origin of the incriminating strain to Belgaum. Interpretation & conclusions: Our study reported the first twin outbreak of cholera in two remote areas of Bijapur district, Karnataka, south India. It also indicated the need for immediate preparedness to deal with such emergencies.
MeSH term(s)	Cholera/drug therapy ; Cholera/epidemiology ; Cholera/microbiology ; Cholera/pathology ; Cholera Toxin/isolation & purification ; DNA Fingerprinting ; Diarrhea/epidemiology ; Diarrhea/microbiology ; Diarrhea/pathology ; Disease Outbreaks ; Feces/microbiology ; Humans ; India ; Vibrio cholerae O1/classification ; Vibrio cholerae O1/isolation & purification ; Vibrio cholerae O1/pathogenicity ; Water Microbiology
Chemical Substances	Cholera Toxin (9012-63-9)
Language	English
Publishing date	2014-09
Publishing country	India
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	390883-5
ISSN	0971-5916 ; 0019-5340
ISSN	0971-5916 ; 0019-5340
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