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Article: Protective efficacy of Alum adjuvanted Amidase protein vaccine against Staphylococcus aureus infection in multiple mouse models

Suresh, Maneesha K. / Vasudevan, Anil Kumar / Biswas, Lalitha / Biswas, Raja

Journal of applied microbiology. 2022 Feb., v. 132, no. 2

2022

Abstract: AIMS: Staphylococcus aureus is an opportunistic pathogen of humans. No commercial vaccine is available to combat S. aureus infections. In this study, we have investigated the protective immune response generated by S. aureus non‐covalently associated ... ...

Abstract	AIMS: Staphylococcus aureus is an opportunistic pathogen of humans. No commercial vaccine is available to combat S. aureus infections. In this study, we have investigated the protective immune response generated by S. aureus non‐covalently associated cell wall surface protein N‐acetylmuramoyl‐L‐alanine amidase (AM) in combination with Alum (Al) and heat‐killed S. aureus (hkSA) using murine models. METHODS AND RESULTS: BALB/c mice were immunized with increasing concentrations of AM antigen or hkSA to determine their optimum concentration for vaccination. Fifty micrograms of AM and hkSA each were found to generate maximum anti‐AM IgG antibody production. BALB/c mice were immunized next with 50 µg of AM, 50 µg of hKSA and 1 mg Al vaccine formulation. Vaccine efficacy was validated by challenging immunized BALB/c mice with S. aureus Newman and three clinical methicillin‐resistant S. aureus strains. AM‐hkSA‐Al–immunized mice generated high anti‐AM IgG antibody response with IgG1 and IgG2b as the predominant immunoglobulin subtypes. Increased survival (60%–90%) with decreased clinical disease symptoms was observed in the vaccinated BALB/c mice group. A significantly lower bacterial load and decreased kidney abscess formation was observed following the challenge with S. aureus in the vaccinated BALB/c mice group. Furthermore, the efficacy of AM‐hkSA‐Al vaccine was also validated using C57 BL/6 and Swiss albino mice. CONCLUSIONS: Using murine infection models, we have demonstrated that AM‐hkSA‐Al vaccine would be effective in preventing S. aureus infections. SIGNIFICANCE AND IMPACT OF STUDY: AM‐hkSA‐Al vaccine elicited strong immune response and may be considered for future vaccine design against S. aureus infections.
Keywords	N-acetylmuramoyl-L-alanine amidase ; abscess ; albino ; alum ; amidase ; antibody formation ; antigens ; immunoglobulin G ; kidneys ; methicillin-resistant Staphylococcus aureus ; mice ; microbial load ; opportunistic pathogens ; surface proteins ; vaccination ; vaccine development ; vaccines
Language	English
Dates of publication	2022-02
Size	p. 1422-1434.
Publishing place	John Wiley & Sons, Ltd
Document type	Article
Note	JOURNAL ARTICLE
ZDB-ID	1358023-1
ISSN	1365-2672 ; 1364-5072
ISSN (online)	1365-2672
ISSN	1364-5072
DOI	10.1111/jam.15291
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Article ; Online: Protective efficacy of Alum adjuvanted Amidase protein vaccine against Staphylococcus aureus infection in multiple mouse models.

Suresh, Maneesha K / Vasudevan, Anil Kumar / Biswas, Lalitha / Biswas, Raja

Journal of applied microbiology

2021 Volume 132, Issue 2, Page(s) 1422–1434

Abstract: Aims: Staphylococcus aureus is an opportunistic pathogen of humans. No commercial vaccine is available to combat S. aureus infections. In this study, we have investigated the protective immune response generated by S. aureus non-covalently associated ... ...

Abstract	Aims: Staphylococcus aureus is an opportunistic pathogen of humans. No commercial vaccine is available to combat S. aureus infections. In this study, we have investigated the protective immune response generated by S. aureus non-covalently associated cell wall surface protein N-acetylmuramoyl-L-alanine amidase (AM) in combination with Alum (Al) and heat-killed S. aureus (hkSA) using murine models. Methods and results: BALB/c mice were immunized with increasing concentrations of AM antigen or hkSA to determine their optimum concentration for vaccination. Fifty micrograms of AM and hkSA each were found to generate maximum anti-AM IgG antibody production. BALB/c mice were immunized next with 50 µg of AM, 50 µg of hKSA and 1 mg Al vaccine formulation. Vaccine efficacy was validated by challenging immunized BALB/c mice with S. aureus Newman and three clinical methicillin-resistant S. aureus strains. AM-hkSA-Al-immunized mice generated high anti-AM IgG antibody response with IgG1 and IgG2b as the predominant immunoglobulin subtypes. Increased survival (60%-90%) with decreased clinical disease symptoms was observed in the vaccinated BALB/c mice group. A significantly lower bacterial load and decreased kidney abscess formation was observed following the challenge with S. aureus in the vaccinated BALB/c mice group. Furthermore, the efficacy of AM-hkSA-Al vaccine was also validated using C57 BL/6 and Swiss albino mice. Conclusions: Using murine infection models, we have demonstrated that AM-hkSA-Al vaccine would be effective in preventing S. aureus infections. Significance and impact of study: AM-hkSA-Al vaccine elicited strong immune response and may be considered for future vaccine design against S. aureus infections.
MeSH term(s)	Alum Compounds ; Amidohydrolases ; Animals ; Antibodies, Bacterial ; Methicillin-Resistant Staphylococcus aureus ; Mice ; Mice, Inbred BALB C ; Staphylococcal Infections/prevention & control ; Staphylococcal Vaccines ; Staphylococcus aureus ; Vaccine Efficacy ; Vaccines
Chemical Substances	Alum Compounds ; Antibodies, Bacterial ; Staphylococcal Vaccines ; Vaccines ; aluminum sulfate (34S289N54E) ; Amidohydrolases (EC 3.5.-)
Language	English
Publishing date	2021-09-17
Publishing country	England
Document type	Journal Article
ZDB-ID	1358023-1
ISSN	1365-2672 ; 1364-5072
ISSN (online)	1365-2672
ISSN	1364-5072
DOI	10.1111/jam.15291
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Article: The cell surface adhesins of Mycobacterium tuberculosis

Vinod, Vivek / Vijayrajratnam, Sukhithasri / Vasudevan, Anil Kumar / Biswas, Raja

Microbiological research. 2020 Feb., v. 232

2020

Abstract: Bacterial cell surface adhesins play a major role in facilitating host colonization and subsequent establishment of infection. The surface of Mycobacterium tuberculosis, owing to the complex architecture of its cell envelope, expresses numerous adhesins ... ...

Abstract	Bacterial cell surface adhesins play a major role in facilitating host colonization and subsequent establishment of infection. The surface of Mycobacterium tuberculosis, owing to the complex architecture of its cell envelope, expresses numerous adhesins with varied chemical nature, including proteins, lipids, lipoproteins, glycoproteins and glycopolymers. Studies on mycobacterial adhesins show that they bind with multifarious host receptors and extracellular matrix (ECM) components. In this review we have highlighted the adhesins that are abundantly present on the mycobacterial surface and their interactions with host receptors. M. tuberculosis interacts with various host cell surface receptors such as toll like receptors, C-type lectin receptors, scavenger receptors, and Fc and complement receptors. Apart from these, ECM components like fibronectin, collagen, elastin, laminin, fibrillin and vitronectin also provide binding sites for surface adhesins of the tubercle bacilli. M. tuberculosis adhesins include proteins with and without signal peptide sequence and transmembrane proteins. Other surface adhesin macromolecules of M. tuberculosis comprises of lipids, glycolipids and glycopolymers. The interaction between the mycobacterial adhesins and their host receptors result in adhesion of the microbe to the host cells, induction of immune response and aid in the pathogenesis of the disease. A thorough understanding of the different M. tuberculosis surface adhesins and host receptors will provide a better picture of interaction between them at molecular level. The information gained on adhesins and host receptors will prove beneficial in developing novel therapeutic strategies such as the use of anti-adhesin molecules to hinder the adhesion of bacteria to the host cells, thereby preventing establishment of infection. The surface molecules discussed in this review will also benefit in identification of new drug targets, diagnostic markers or vaccine candidates against the deadly pathogen.
Keywords	Bacilli ; Mycobacterium tuberculosis ; adhesins ; adhesion ; bacteria ; bacterial adhesion ; binding sites ; collagen ; complement ; elastin ; extracellular matrix ; fibrillins ; fibronectins ; glycolipids ; glycoproteins ; immune response ; laminin ; lectins ; lipoproteins ; pathogenesis ; pathogens ; receptors ; signal peptide ; therapeutics ; transmembrane proteins ; vaccines
Language	English
Dates of publication	2020-02
Publishing place	Elsevier GmbH
Document type	Article
ZDB-ID	1189614-0
ISSN	1618-0623 ; 0944-5013
ISSN (online)	1618-0623
ISSN	0944-5013
DOI	10.1016/j.micres.2019.126392
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Article ; Online: The cell surface adhesins of Mycobacterium tuberculosis.

Vinod, Vivek / Vijayrajratnam, Sukhithasri / Vasudevan, Anil Kumar / Biswas, Raja

Microbiological research

2019 Volume 232, Page(s) 126392

Abstract	Bacterial cell surface adhesins play a major role in facilitating host colonization and subsequent establishment of infection. The surface of Mycobacterium tuberculosis, owing to the complex architecture of its cell envelope, expresses numerous adhesins with varied chemical nature, including proteins, lipids, lipoproteins, glycoproteins and glycopolymers. Studies on mycobacterial adhesins show that they bind with multifarious host receptors and extracellular matrix (ECM) components. In this review we have highlighted the adhesins that are abundantly present on the mycobacterial surface and their interactions with host receptors. M. tuberculosis interacts with various host cell surface receptors such as toll like receptors, C-type lectin receptors, scavenger receptors, and Fc and complement receptors. Apart from these, ECM components like fibronectin, collagen, elastin, laminin, fibrillin and vitronectin also provide binding sites for surface adhesins of the tubercle bacilli. M. tuberculosis adhesins include proteins with and without signal peptide sequence and transmembrane proteins. Other surface adhesin macromolecules of M. tuberculosis comprises of lipids, glycolipids and glycopolymers. The interaction between the mycobacterial adhesins and their host receptors result in adhesion of the microbe to the host cells, induction of immune response and aid in the pathogenesis of the disease. A thorough understanding of the different M. tuberculosis surface adhesins and host receptors will provide a better picture of interaction between them at molecular level. The information gained on adhesins and host receptors will prove beneficial in developing novel therapeutic strategies such as the use of anti-adhesin molecules to hinder the adhesion of bacteria to the host cells, thereby preventing establishment of infection. The surface molecules discussed in this review will also benefit in identification of new drug targets, diagnostic markers or vaccine candidates against the deadly pathogen.
MeSH term(s)	Adhesins, Bacterial/chemistry ; Adhesins, Bacterial/metabolism ; Antitubercular Agents ; Bacterial Proteins ; Binding Sites ; Extracellular Matrix Proteins/chemistry ; Extracellular Matrix Proteins/metabolism ; Host-Pathogen Interactions/physiology ; Humans ; Mycobacterium tuberculosis/metabolism ; Protein Sorting Signals ; Receptors, Cell Surface/chemistry ; Receptors, Cell Surface/metabolism ; Vesicular Transport Proteins
Chemical Substances	Adhesins, Bacterial ; Antitubercular Agents ; Bacterial Proteins ; Extracellular Matrix Proteins ; Protein Sorting Signals ; Receptors, Cell Surface ; Vesicular Transport Proteins
Language	English
Publishing date	2019-12-09
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	1189614-0
ISSN	1618-0623 ; 0944-5013
ISSN (online)	1618-0623
ISSN	0944-5013
DOI	10.1016/j.micres.2019.126392
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Article ; Online: COVID-19 related multisystem inflammatory syndrome in children (MIS-C): a hospital-based prospective cohort study from Kerala, India.

Tiwari, Arun / Balan, Suma / Rauf, Abdul / Kappanayil, Mahesh / Kesavan, Sajith / Raj, Manu / Sivadas, Suchitra / Vasudevan, Anil Kumar / Chickermane, Pranav / Vijayan, Ajay / John, Shaji Thomas / Ck, Sasidharan / Krishnan, Raghuram A / Sudhakar, Abish

BMJ paediatrics open

2021 Volume 5, Issue 1, Page(s) e001195

Abstract: Objectives: To study (1) epidemiological factors, clinical profile and outcomes of COVID-19 related multisystem inflammatory syndrome in children (MIS-C), (2) clinical profile across age groups, (3) medium-term outcomes and (4) parameters associated ... ...

Abstract	Objectives: To study (1) epidemiological factors, clinical profile and outcomes of COVID-19 related multisystem inflammatory syndrome in children (MIS-C), (2) clinical profile across age groups, (3) medium-term outcomes and (4) parameters associated with disease severity. Design: Hospital-based prospective cohort study. Setting: Two tertiary care centres in Kerala, India. Participants: Diagnosed patients of MIS-C using the case definition of Centres for Disease Control and Prevention. Statistical analysis: Pearson χ Results: We report 41 patients with MIS-C, mean age was 6.2 (4.0) years, and 33 (80%) were previously healthy. Echocardiogram was abnormal in 23 (56%), and coronary abnormalities were noted in 15 (37%) patients. Immunomodulatory therapy was administered to 39 (95%), steroids and IVIg both were used in 35 (85%) and only steroids in 3 (7%) patients. Intensive care was required in 36 (88%), mechanical ventilation in 8 (20%), inotropic support in 21 (51%), and 2 (5%) patients died. Mechanical ventilation requirement in MIS-C was associated with hyperferritinaemia (p=0.001). Thirty-seven patients completed 3 months follow-up by April 2021, of whom 6 (16%) patients had some residual echocardiographic changes. Conclusions: Patients with MIS-C in our cohort had varied clinical manifestations ranging from fever with mild gastrointestinal and mucocutaneous involvement to fatal multiorgan dysfunction. Immediate and medium-term outcomes remain largely excellent except for the echocardiographic sequelae in a few patients which are also showing a resolving trend. Hyperferritinaemia was associated with the requirement of mechanical ventilation.
MeSH term(s)	COVID-19/complications ; Child ; Hospitals ; Humans ; India ; Prospective Studies ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome
Language	English
Publishing date	2021-10-18
Publishing country	England
Document type	Journal Article
ISSN	2399-9772
ISSN (online)	2399-9772
DOI	10.1136/bmjpo-2021-001195
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Article ; Online: Understanding the molecular differential recognition of muramyl peptide ligands by LRR domains of human NOD receptors.

Vijayrajratnam, Sukhithasri / Pushkaran, Anju Choorakottayil / Balakrishnan, Aathira / Vasudevan, Anil Kumar / Biswas, Raja / Mohan, Chethampadi Gopi

The Biochemical journal

2017 Volume 474, Issue 16, Page(s) 2691–2711

Abstract: Human nucleotide-binding oligomerization domain proteins, hNOD1 and hNOD2, are host intracellular receptors with C-terminal leucine-rich repeat (LRR) domains, which recognize specific bacterial peptidoglycan (PG) fragments as their ligands. The ... ...

Abstract	Human nucleotide-binding oligomerization domain proteins, hNOD1 and hNOD2, are host intracellular receptors with C-terminal leucine-rich repeat (LRR) domains, which recognize specific bacterial peptidoglycan (PG) fragments as their ligands. The specificity of this recognition is dependent on the third amino acid of the stem peptide of the PG ligand, which is usually
MeSH term(s)	Acetylmuramyl-Alanyl-Isoglutamine/chemistry ; Acetylmuramyl-Alanyl-Isoglutamine/genetics ; Acetylmuramyl-Alanyl-Isoglutamine/metabolism ; HEK293 Cells ; Humans ; Ligands ; Molecular Docking Simulation ; Nod1 Signaling Adaptor Protein/chemistry ; Nod1 Signaling Adaptor Protein/genetics ; Nod1 Signaling Adaptor Protein/metabolism ; Nod2 Signaling Adaptor Protein/chemistry ; Nod2 Signaling Adaptor Protein/genetics ; Nod2 Signaling Adaptor Protein/metabolism ; Protein Domains
Chemical Substances	Ligands ; NOD1 protein, human ; NOD2 protein, human ; Nod1 Signaling Adaptor Protein ; Nod2 Signaling Adaptor Protein ; Acetylmuramyl-Alanyl-Isoglutamine (53678-77-6)
Language	English
Publishing date	2017-07-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2969-5
ISSN	1470-8728 ; 0006-2936 ; 0306-3275 ; 0264-6021
ISSN (online)	1470-8728
ISSN	0006-2936 ; 0306-3275 ; 0264-6021
DOI	10.1042/BCJ20170220
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Article ; Online: Combination of Repurposed Drug Diosmin with Amoxicillin-Clavulanic acid Causes Synergistic Inhibition of Mycobacterial Growth.

Pushkaran, Anju Choorakottayil / Vinod, Vivek / Vanuopadath, Muralidharan / Nair, Sudarslal Sadasivan / Nair, Shantikumar V / Vasudevan, Anil Kumar / Biswas, Raja / Mohan, Chethampadi Gopi

Scientific reports

2019 Volume 9, Issue 1, Page(s) 6800

Abstract: Effective therapeutic regimens for the treatment of tuberculosis (TB) are limited. They are comprised of multiple drugs that inhibit the essential cellular pathways in Mycobacterium tuberculosis (Mtb). The present study investigates an approach which ... ...

Abstract	Effective therapeutic regimens for the treatment of tuberculosis (TB) are limited. They are comprised of multiple drugs that inhibit the essential cellular pathways in Mycobacterium tuberculosis (Mtb). The present study investigates an approach which enables a combination of Amoxicillin-Clavulanic acid (AMC) and a repurposed drug for its synergistic effect towards TB treatment. We identified Diosmin (DIO), by targeting the active site residues of L,D-transpeptidase (Ldt) enzymes involved in Mtb cell wall biosynthesis by using a structure-based drug design method. DIO is rapidly converted into aglycone form Diosmetin (DMT) after oral administration. Binding of DIO or DMT towards Ldt enzymes was studied using molecular docking and bioassay techniques. Combination of DIO (or DMT) and AMC exhibited higher mycobactericidal activity against Mycobacterium marinum as compared to individual drugs. Scanning electron microscopy study of M. marinum treated with AMC-DIO and AMC-DMT showed marked cellular leakage. M. marinum infected Drosophila melanogaster fly model showed an increased fly survival of ~60% upon treatment with a combination of AMC and DIO (or DMT). Finally, the enhanced in vitro antimicrobial activity of AMC-DIO was validated against Mtb H37Ra and a MDR clinical isolate. Our results demonstrate the potential for AMC and DIO (or DMT) as a synergistic combination for the treatment of TB.
MeSH term(s)	Amino Acid Sequence ; Amoxicillin-Potassium Clavulanate Combination/pharmacology ; Animals ; Antitubercular Agents/chemistry ; Antitubercular Agents/pharmacology ; Bacterial Proteins/metabolism ; Diosmin/pharmacology ; Drosophila melanogaster/drug effects ; Drosophila melanogaster/growth & development ; Drug Design ; Drug Repositioning/methods ; Drug Therapy, Combination ; Male ; Microbial Sensitivity Tests ; Molecular Docking Simulation ; Mycobacterium tuberculosis/drug effects ; Mycobacterium tuberculosis/growth & development ; Sequence Homology ; Tuberculosis/drug therapy ; Tuberculosis/metabolism ; Tuberculosis/microbiology
Chemical Substances	Antitubercular Agents ; Bacterial Proteins ; Amoxicillin-Potassium Clavulanate Combination (74469-00-4) ; Diosmin (7QM776WJ5N)
Language	English
Publishing date	2019-05-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-019-43201-x
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Article: Evidence of new particle formation during post monsoon season over a high-altitude site of the Western Ghats, India

Leena, Parakkatt Parambil / Govindan Pandithurai / Kundan. K. Dani / Palani Murugavel / Sunil. M. Sombawne / Vasudevan Anil Kumar

Toxicological and environmental chemistry. 2017 Apr. 21, v. 99, no. 4

2017

Abstract: The formation of ultrafine particles, their growth, and associated characteristic features has been studied during new particle formation events over a high-altitude station of the Western Ghats during the 2014 post-monsoon season. Most of the events ... ...

Abstract	The formation of ultrafine particles, their growth, and associated characteristic features has been studied during new particle formation events over a high-altitude station of the Western Ghats during the 2014 post-monsoon season. Most of the events were observed during noon time where particle bursts in the nucleation-mode size range from 5 to 25Â nm followed by sustained growth in size. This phenomenon persists for â¼4â8Â h with a growth rate of 1â2Â nm h âÂ¹. Peak concentrations of nucleation-mode particles during the event generally vary from 2300 to 5000 cm âÂ³. The mean growth rate is 1.4 Â± 0.42Â nm h âÂ¹, particle formation rate is 1.14 Â± 0.22 cm âÂ³ s âÂ¹, coagulation sink is 0.35 Â± 0.22 cm âÂ³ s âÂ¹, and condensational sink is 15.4 Â± 2.6âÃâ10 âÂ³ s âÂ¹. All these values are comparable with earlier results from Indian region. Comparison of size-segregated particle number concentration during days of new particle formation events and those without new particle formation were carried out showing a distinct variation in nucleation and Aitken mode with least variability associated with the accumulation mode.
Keywords	chemistry ; coagulation ; monsoon season ; India
Language	English
Dates of publication	2017-0421
Size	p. 652-664.
Publishing place	Taylor & Francis
Document type	Article
ISSN	1029-0486
DOI	10.1080/02772248.2016.1274031
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Article ; Online: Bacterial peptidoglycan with amidated meso-diaminopimelic acid evades NOD1 recognition: an insight into NOD1 structure-recognition.

Vijayrajratnam, Sukhithasri / Pushkaran, Anju Choorakottayil / Balakrishnan, Aathira / Vasudevan, Anil Kumar / Biswas, Raja / Mohan, Chethampadi Gopi

The Biochemical journal

2016 Volume 473, Issue 24, Page(s) 4573–4592

Abstract: Nucleotide-binding oligomerization domain-containing protein 1 (NOD1) is an intracellular pattern recognition receptor that recognizes bacterial peptidoglycan (PG) containing meso-diaminopimelic acid (mesoDAP) and activates the innate immune system. ... ...

Abstract	Nucleotide-binding oligomerization domain-containing protein 1 (NOD1) is an intracellular pattern recognition receptor that recognizes bacterial peptidoglycan (PG) containing meso-diaminopimelic acid (mesoDAP) and activates the innate immune system. Interestingly, a few pathogenic and commensal bacteria modify their PG stem peptide by amidation of mesoDAP (mesoDAP
MeSH term(s)	Amino Acid Sequence ; Diaminopimelic Acid/chemistry ; Diaminopimelic Acid/metabolism ; Humans ; Molecular Dynamics Simulation ; Molecular Sequence Data ; Nod1 Signaling Adaptor Protein/chemistry ; Nod1 Signaling Adaptor Protein/metabolism ; Peptidoglycan/chemistry ; Peptidoglycan/metabolism ; Protein Binding ; Protein Structure, Secondary
Chemical Substances	NOD1 protein, human ; Nod1 Signaling Adaptor Protein ; Peptidoglycan ; Diaminopimelic Acid (583-93-7)
Language	English
Publishing date	2016-12-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2969-5
ISSN	1470-8728 ; 0006-2936 ; 0306-3275 ; 0264-6021
ISSN (online)	1470-8728
ISSN	0006-2936 ; 0306-3275 ; 0264-6021
DOI	10.1042/BCJ20160817
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Article: Congenital Cystic Adenomatoid Malformation: A Tertiary Care Hospital Experience.

Mehta, Asmita Anilkumar / Viswanathan, Naveen / Vasudevan, Anil Kumar / Paulose, Roopa / Abraham, Mohan

Journal of clinical and diagnostic research : JCDR

2016 Volume 10, Issue 11, Page(s) SC01–SC04

Abstract: Introduction: Congenital Cystic Adenomatoid Malformation (CCAM) is an uncommon developmental deformity affecting the terminal respiratory structures. It is characterized by broncho pulmonary foregut malformations. The reason behind it is an arrest in ... ...

Abstract	Introduction: Congenital Cystic Adenomatoid Malformation (CCAM) is an uncommon developmental deformity affecting the terminal respiratory structures. It is characterized by broncho pulmonary foregut malformations. The reason behind it is an arrest in lung development between 4 Aim: The present study was conducted to assess the clinical and radiological profile and also to study the role of surgical intervention in patients with CCAM. Materials and methods: All patients with clinical suspicion or provisional diagnosis of CCAM were included in the study. A clinical questionnaire was prepared to collect data. Computed Tomography (CT) chest with High Resolution Computed Tomography (HRCT) was done for all the patients. Patients were assessed by paediatric surgeon and eligible patients were operated. The procedure conducted was usually open thoracotomy under general anaesthesia. The affected lobes were removed and specimens were sent for histopathological analysis. All included patients were followed up prospectively to find out about their current level of health. Via telephonic interview they were asked about their overall growth, quality of life, activity, rate of respiratory infections and requirement of hospital admission. Results: Total 15 patients with diagnosis of CCAM were included in the study. Of them, 8 (53.3%) were male. The commonest presentation was cough 13(86%), breathing difficulty 11(73%), fever 9(60%), recurrent pneumonia 4(26%), hypoxia requiring oxygen supplementation 6(40%), others 2(12%). Thirteen patients required surgical intervention and underwent lobectomy. There were 2 cases of type I, one each of type II and III, 3 case of type IV while 5 were intermediate type. There was no procedure related mortality. The median duration of hospital stay and all were successfully discharged with median duration of stay 11±16 days. Conclusion: The study concludes that if recognized early, surgical removal of affected lung prevents the complications like recurrent pulmonary infections. The surgery is well tolerated without any post-operative mortality or morbidity.
Language	English
Publishing date	2016-11-01
Publishing country	India
Document type	Journal Article
ZDB-ID	2775283-5
ISSN	0973-709X ; 2249-782X
ISSN (online)	0973-709X
ISSN	2249-782X
DOI	10.7860/JCDR/2016/19205.8775
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