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Summary The diagnosis of dog-mediated rabies in humans and animals has greatly benefited from technical advances in the laboratory setting. Approaches to diagnosis now include the detection of rabies virus (RABV), RABV RNA, or RABV antigens. These assays are important tools in the current efforts aimed at the global elimination of dog-mediated rabies. The assays available for use in laboratories are reviewed herein, as well as their strengths and weaknesses, which vary with the types of sample analyzed. Depending on the setting, however, the public health objectives and use of RABV diagnosis in the field will also vary. In non-endemic settings, the detection of all introduced or emergent animal or human cases justifies exhaustive testing. In dog RABV-endemic settings, such as rural areas of developing countries where most cases occur, the availability of or access to testing may be severely constrained. Thus, these issues are also discussed along with a proposed strategy to prioritize testing while access to rabies testing in the resource-poor, highly endemic setting is improved. As the epidemiological situation of rabies in a country evolves, the strategy should shift from that of an endemic setting to one more suitable for a decreased rabies incidence following the implementation of efficient control measures and when nearing the target of dog-mediated rabies elimination. [ABSTRACT FROM AUTHOR]

Typhoid fever remains a serious problem in many developing countries. Due to resistance to multiple first line drugs, azithromycin has evolved as an important drug in the treatment of typhoid. While therapy with azithromycin is highly effective, no clinically validated mean inhibitory concentration (MIC) break points or disc diffusion cutoff guidelines are available so far. We describe an Indian adult with clinical and microbiological failure to azithromycin despite low azithromycin MIC. [ABSTRACT FROM AUTHOR]

Background: Infectious diarrhoea particularly due to pathogenic bacteria is a major health problem in developing countries, including India. Despite significant reports of diarrhoeagenic Escherichia coli (DEC) pathotypes across the globe, there is paucity of studies which reveal their relatedness with respect to their isolation from different sources. This present study determines isolation and identification of DEC pathotypes from different sources, their genetic characterization and antibiogram sensitivity profiling. Methods & Materials: A total of 336 samples comprising of diarrhoeic stool samples from infants (n = 103), young animals (n = 106), foods and associated environmental sources (n = 127) were screened for E. coli. The identified E. coli were confirmed as DEC pathotypes by using PCR based assays. These isolates were further studied for their genetic diversity using Pulse Field Gel Electrophoresis (PFGE) subtyping tool and their antibiogram profilewas determined against seven commonly used drugs. Results: Of the four DEC pathotypes investigated, Enteroaggregative E. coli (EAEC) was found to be the predominant pathogen with an isolation rate of 16.50% from infants, 17.92% from young animals and 10.24% from foods and environmental sources. These EAEC isolates, on further characterization revealed predominance of 'atypical' EAEC, with an isolation rate of 10.68% from infants, 15.09% from young animals and 10.24% from foods and associated environmental sources. On PFGE analysis, discrimination was also evident withinDECpathotypes, as only closely relatedEAECisolates clustered together irrespective of their source of isolation. Further, higher antibiotic resistance pattern was observed among the isolated DEC pathotypes as almost 86.44% of isolates were found to be resistant against ≥3 tested drugs. Conclusion: EAEC pathotype in particular 'atypical' strains were found to be the predominant pathogen. On PFGE analysis, sharing and circulation of EAEC isolates between human and animal, including foods and associated environmental sources was evident. Besides this, an alarming antimicrobial resistance profile was observed for majority of the recovered DEC pathotype isolates. [ABSTRACT FROM AUTHOR]