Identification of the etiological agent in severe pneumonia is limited by factors such as the poor yield from blood samples and the presence of colonizers in the respiratory tract. Samples from the lower respiratory tract could be more representative of the etiological agent causing pneumonia. We conducted a case-control study to determine the etiology of community-acquired severe pneumonia requiring intubation. This case-control study was conducted from 2017 to 2019 at Christian Medical College, Vellore. The cases included children between 1 and 24 months of age who were intubated for community-acquired severe pneumonia. The controls included children undergoing intubation for elective surgeries. Tracheal aspirates and nasopharyngeal swabs were obtained from all cases and controls. Additionally, a nonbronchoscopic bronchoalveolar lavage was obtained from all cases. The total nucleic acid extracted from all samples was tested for multiple respiratory pathogens using CDC-developed TaqMan Array Cards (Thermo Fisher Scientific, Waltham, MA) on the QuantStudio 12K Flex platform (Thermo Fisher Scientific). A total of 100 samples were collected from the 34 cases, and 64 samples were collected from the 32 controls. Respiratory syncytial virus and Streptococcus pneumoniae (S. pneumoniae) were the most commonly isolated pathogens. Respiratory syncytial virus detection rates were significantly higher in cases compared with controls in nasopharyngeal (odds ratio: 10.45; 95% CI: 1.25-88.25) samples. Streptococcus pneumoniae was more frequently detected in nasopharyngeal samples in cases than controls; however, this difference was not statistically significant. Respiratory syncytial virus and S. pneumoniae were the most commonly isolated pathogens in cases of severe pneumonia that required intubation in children between 1 and 24 months of age in Vellore, India.

Strongyloides stercoralis is a soil-transmitted nematode that leads to asymptomatic or mild infections in immunocompetent hosts; however, in immunocompromised individuals, it can lead to hyperinfection and disseminated strongyloidiasis that can be fatal. Central nervous system (CNS) involvement is rare but can result in severe complications, such as meningitis. Diagnosis is challenging because of the low sensitivity of conventional microscopy. Molecular techniques, such as quantitative polymerase chain reaction (qPCR), are more sensitive, especially for detecting S. stercoralis in cerebrospinal fluid (CSF). We report a case of a 28-year-old female with newly diagnosed advanced HIV infection with CD4 counts of 54 cells/µL presenting with disseminated strongyloidiasis and CNS involvement. She subsequently developed Escherichia coli bacteremia and meningitis. Although microscopy of stool and sputum detected the infection, S. stercoralis qPCR in CSF was crucial for diagnosing CNS involvement. This case underscores the importance of molecular diagnosis of CNS strongyloidiasis among high-risk patients to enable timely appropriate therapeutic intervention.

This study aims to identify the distribution of different clostridial species in human infections, sample types, and their antimicrobial susceptibility profile using the E-test method. The samples were processed as per the standard bacteriological techniques. Automated anaerobic gas evacuation-replacement system was used to create anaerobiosis (85% N2, 10% CO2, 5% H2). Antibiotic susceptibility of isolated Clostridium species was performed using gradient diffusion (E strip) method against metronidazole, clindamycin, and penicillin. On antibiotic susceptibility testing by E-test, we have found 96.77% susceptibility to metronidazole, 90.32% susceptibility to penicillin, and 74.19% susceptibility to clindamycin. It can be inferred that the E-test, when performed with the right inoculum, and when given the adequate period of incubation, could be used to reliably perform AST in Clostridium species. It produces a reliable report within 96h of sample processing.