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Introduction: Pneumonia is the single largest infectious cause of death in children worldwide. Aetiology of pneumonia can be identified using multiple diagnostic tools including culture, serology and Polymerase Chain Reaction (PCR); common pathogens include Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, some atypical bacteria like Mycoplasma pneumoniae and Chlamydophila pneumoniae. Aim: The study was undertaken to find out the bacteriological agents causing Community Acquired Pneumonia (CAP) in under five year children and to compare the conventional culture and PCR in identifying the pathogen. Materials and Methods: This cross-sectional study was undertaken in the Department of Microbiology and Department of Paediatrics in a tertiary care centre of Assam, India between March 2016 to September 2018. The study was undertaken with 200 under five year old children who were clinically diagnosed as CAP. Oropharyngeal (OP) swabs and blood culture were processed for bacteriological culture. PCR assay of OP swabs for Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus etc., including atypical bacteria like Mycoplasma pneumoniae and Chlamydophila pneumoniae were performed. Data entry, database management and statistical analysis were performed using Epi-Info software version 7.0. Results: A total of 200 subjects were included in the present study with a male:female ratio of 1.63:1. Most of the study subjects were <11 months of age. Most common isolates were Streptococcus pneumoniae (26.5%) and Staphylococcus aureus (25%) from OP swabs; blood culture revealed mostly Staphylococcus aureus (59%) and Streptococcus pneumoniae (25%). PCR assay of OP swabs were found positive mostly for Staphylococcus aureus (47%), Streptococcus pneumoniae (21.5%) while two children were positive for Haemophilus influenzae; Bordetella pertussis was detected in one child. On evaluation, PCR assay in detecting the bacterial pathogen was found statistically more significant than conventional culture of OP swabs (p<0.05). Conclusion: Staphylococcus aureus and Streptococcus pneumoniae were the most common bacterial organisms in the study. PCR assay was found to be more useful in diagnosing the pathogen for bacterial pneumonia including those difficult to grow in conventional culture. [ABSTRACT FROM AUTHOR]

Introduction: Diphtheria caused by toxigenic Corynebacterium diphtheriae is an acute respiratory infection characterised by pseudomembrane formation in the throat. Although diphtheria is often reported sporadically across India, molecular characterisation of C.diphtheriae strains could play a crucial role in epidemiological investigations. Aim: To perform molecular characterisation of Corynebacterium diphtheriae isolates of faucial diphtheria cases from Assam, North-East India utilising Multi-Locus Sequence Typing (MLST). Materials and Methods: In this cross-sectional study, three isolates were obtained from three different cluster of cases that occurred across two districts of Assam, India for a period from November 2019 to June 2020. The MLST of these three C.diphtheriae isolates were performed in Multidisciplinary Research Unit of Assam Medical College and Hospital by using the 7-gene MLST alleles of C.diphtheriae to determine the Sequence Types (ST). Results: The MLST of the three isolates of this study revealed two distinct STs, ST-588 and ST-576 with multi-clonal lineages with ST-466, reported in C.diphtheriae strains of North Kerala and ST-301 related strains of Bangladesh, respectively. Conclusion: In spite of frequent reports of diphtheria cases from Assam, molecular typing of the C.diphtheriae strains found in North-Eastern region of India has not yet been performed. This is one of the initial investigations from this region of India to use MLST for typing C.diphtheriae strains. Therefore, studies related to molecular characterisation of C.diphtheriae strains found throughout India could immensely help in determining the clonality and diversity existing among these strains. [ABSTRACT FROM AUTHOR]

Diphtheria is still a significant child health problem in countries with low immunization coverage. Reports of diphtheria in adult population are also increasing. Here we describe three recent outbreaks of diphtheria in Dibrugarh district, Assam in two consecutive years. The study was undertaken in Assam Medical College & Hospital, Dibrugarh after the diagnosis of two Diphtheria cases in the month of September and October 2015 and another in January 2016. Outbreak investigation was done after defining operational definition and throat swabs were collected from thirty three (33) individuals including three (3) index cases and thirty (30) close contacts. Diagnosis was done by clinical findings, direct microscopy, bacteriological culture and in-house designed multiplex Polymerase Chain Reaction (PCR) of the isolates for the expression of Corynebacterium diphtheriae specific rpoB gene and tox gene. Out of the 10 confirmed cases, 2 and 7 were in the first two outbreaks while only one in the third outbreak respectively. All the cases were of age > 10 years, unimmunized or partially immunized. The overall mortality was 20%. PCR results revealed all the culture positive isolates to be tox gene positive. Diphtheria is a resurgent problem in our region with a significant age shift towards adult. [ABSTRACT FROM AUTHOR]

Paragonimiasis or lung fluke infection is one of the neglected tropical parasitic disease which is found worldwide. Several endemic foci have been discovered in the Northeast India. Pulmonary paragonimiasis presenting with haemoptysis is generally mistaken for pulmonary tuberculosis. Herein, we present a case of pulmonary paragonimiasis, which initially presented with haemoptysis and remained undiagnosed for two years. The patient was treated with Praziquantel 25mg/kg thrice daily for two days along with the supportive care. Subsequently, on follow up after three months the patient had improved with no fever and cough. [ABSTRACT FROM AUTHOR]