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Introduction of pneumococcal conjugate vaccines (PCVs) reduced the number of cases of pneumococcal disease (PD). However, there is an increase in clinical and economic burden of PD from serotypes that are not part of the existing pneumococcal vaccines, particularly impacting pediatric and elder population. In addition, the regions where the PCV is not available, the disease burden remains high. In this study, immunogenicity and safety of the BE's 14-valent PCV (PNEUBEVAX 14™; BE-PCV-14) containing two additional epidemiologically important serotypes (22F and 33F) was evaluated in infants in comparison to licensed vaccine, Prevenar-13 (PCV-13). This is a pivotal phase-3 single blind randomized active-controlled study conducted at 12 sites across India in 6–8 weeks old healthy infants at 6–10–14 weeks dosing schedule to assess immunogenic non-inferiority and safety of a candidate BE-PCV-14. In total, 1290 infants were equally randomized to receive either BE-PCV-14 or PCV-13. Solicited local reactions and systemic events, adverse events (AEs), serious AEs (SAEs), and medically attended AEs (MAAEs) were recorded. Immunogenicity was assessed by measuring anti-PnCPS (anti-pneumococcal capsular polysaccharide) IgG concentration and functional antibody titers through opsonophagocytic activity (OPA), one month after completing three dose schedule. Cross protection to serotype 6A offered by serotype 6B was also assessed in this study. The safety profile of BE-PCV-14 was comparable to PCV-13 vaccine. Majority of reported AEs were mild in nature. No severe or serious AEs were reported in both the treatment groups. For the twelve common serotypes and for the additional serotypes (22F and 33F) in BE-PCV-14, NI criteria was demonstrated as defined by WHO TRS-977. Primary immunogenicity endpoint was met in terms of IgG immune responses for all 14 serotypesof BE-PCV-14. Moreover, a significant proportion of subjects (69%) seroconverted against serotype 6A, even though this antigen was not present in BE-PCV-14. This indicates that serotype 6B of BE-PCV-14 cross protects serotype 6A. BE-PCV-14 also elicited comparable serotype specific functional OPA immune responses to all the serotypes common to PCV-13. BE-PCV-14 was found to be safe and induced robust and functional serotype specific immune responses to all 14 serotypes. It also elicited cross protective immune response against serotype 6B.These findings suggest that BE-PCV-14 can be safely administered to infants and achieve protection against pneumococcal disease caused by serotypes covered in the vaccine. The study was prospectively registered with clinical trial registry of India – CTRI/2020/02/023129. [ABSTRACT FROM AUTHOR]

Central India faced major dengue outbreaks in 2019 and 2021. In the present study, we aimed to identify the dengue virus serotypes and genotypes circulating in Central India during the COVID pre-pandemic year (2019) and ongoing-pandemic year (2021). For this purpose, the suspected cases were first tested by serological assays. Sero-positive samples were then subjected to molecular diagnosis by RT-PCR and semi-nested PCR. The serotypes obtained were confirmed by nucleotide sequencing. A phylogenetic analysis of serotypes was performed to identify the circulating genotypes. All four DENV serotypes were detected during 2019 and 2021, with the predominance of DENV2. Cases with multiple DENV serotype infections were also identified, involving DENV-2 in all the coinfections. Genotyping revealed that DENV-1 (Genotype V, American/African), DENV-2 (Genotype IV, Cosmopolitan), DENV-3 (Genotype III, Cosmopolitan), and DENV-4 (Genotype I) were involved during both outbreaks. DENV-2 detected in 2019 and 2021 has diverged from the previous strains detected in Central India (2016 and 2018), which may account for the higher transmission of DENV-2 during these outbreaks. The detection of heterologous DENV serotypes with high transmission efficiency calls for continuous viral monitoring and surveillance, which will contribute to a better understanding of changing viral dynamics and transmission patterns. [ABSTRACT FROM AUTHOR]

Dengue fever is an endemic disease in India, transmitted by an infected mosquito bite. In India, the number of concurrent infections and the circulation of multiple dengue virus (DENV) serotypes has increased in recent decades. Molecular surveillance among the DENV serotype is important to keep track of the circulating serotypes, evolutionary changes, and key mutations that can alter the diagnostics. The current study included patients admitted for dengue in the Eastern Uttar Pradesh (E-UP) region during 2018-2019. The genetic characterization of the circulating DENV was accomplished through partial CprM (511 bp) gene amplification via reverse transcriptase polymerase chain reaction and sequencing. Phylogenetic analysis revealed the circulation of all four DENV1-4 serotypes. DENV-2 was the most abundant serotype (44%, 27/61), followed by DENV-3 (32%, 20/61). DENV-1 had a 16% (10/61) predominance, while DENV-4 (6%, 4/61) was found to be the least abundant serotype. DENV-2 genotypes were distributed among lineages I (7.4%), II (85%) and III (7.4%) of genotype IV, DENV-3 to lineage III of genotype III, DENV-1 to genotype III; DENV-2 to lineage B (75%) and C (25%) of genotype I. This primary report on the co-circulation of DENV1-4 serotypes from the E-UP region highlights the requirement of continuous molecular surveillance for monitoring circulating DENV serotypes. [ABSTRACT FROM AUTHOR]

Hypervirulent Klebsiella pneumoniae (hvKp) is an emerging pathogen and causes endophthalmitis, liver abscess, osteomyelitis, meningitis, and necrotizing soft tissue infections in both immunodeficient and healthy people. The acquisition of the antibiotic resistance genes of hvKp has become an emerging concern throughout the globe. In this study, a total of 74 K. pneumoniae isolates were collected and identified by VITEK2 and bla SHV  gene amplification. Out of these, 18.91% (14/74) isolates were identified as hvKp by both phenotypic string test and genotypic iucA PCR amplification. The antibiotic susceptibility revealed that 57.14% (8/14) isolates were multidrug-resistant (MDR) and 35.71% (5/14) isolates were extremely drug-resistant (XDR). All the isolates were resistant to β-lactam, β-lactamase + inhibitor groups of antibiotics, and the least resistance to colistin. Of 14 hvKp isolates, all isolates are positive for iroB (100%), followed by iutA (92.85%), peg344 (85.71%), rmpA (57.14%), and magA (21.42%) genes. Among serotypes, K1 was the most prevalent serotype 21.4% (3/14), followed by K5 14.3% (2/14). The most common carbapenemase gene was bla OXA-48 (78.57%) followed by bla NDM (14.28%) and bla KPC (14.28%) which co-carried multiple resistance genes such as bla SHV (100%), bla CTX-M (92.85%), and bla TEM (78.57%). About 92.85% (13/14) of hvKp isolates were strong biofilm producers, while one isolate (hvKp 10) was the only moderate biofilm producer. The (GTG)5-PCR molecular typing method revealed high diversity among the hvKp isolates in the tertiary care hospital. Our findings suggest that MDR-hvKp is an emerging pathogen and a challenge for clinical practice. In order to avoid hvKp strain outbreaks in hospital settings, robust infection control and effective surveillance should be implemented., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background and Objectives: In recent decades, the incidence of dengue has increased dramatically. In dengue-endemic countries, changes in dengue virus serotypes, genotypes, and lineages have been reported. This study was designed to detect and characterize the dengue virus isolates circulating in North India by serological and molecular techniques. Materials and Methods: This study was conducted at the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. NS1 antigen and IgM antibody against dengue were detected by ELISA methods, viral RNA was extracted and amplified by conventional PCR and one-step single-tube multiplex PCR. The purified PCR products were cycle sequenced and a database search was implemented for the confirmation of the sequence product. Phylogenetic analysis was carried out with previously reported sequences. Results: Among 1509 samples, 205 (13.6%) were found positive for IgM antibodies with the highest number (n=67) among the 21 to 30 years age group with peak positivity during post-monsoon months. Among acute samples, NS1 antigen was positive in 62.9%. Seven patients out of 13 had dengue viral RNA in PCR. It comprised six DENV-2 serotypes and one DENV-3 serotype. On phylogenetic analysis, DENV-2 strains grouped with genotype IV and DENV-3 with genotype III. Conclusion: Dengue infection was found frequently during post-monsoon season. The positivity rate of the dengue NS1 antigen test was greater than that of the antibody test. The dengue isolates were characterized as genotype IV and genotype III of DENV-2 and DENV-3 respectively. [ABSTRACT FROM AUTHOR]

Dengue virus (DENV) infection is prevalent in tropical and subtropical regions of the world, which is fatal if untreated symptomatically. Emergence of new genotype within serotypes led to enhanced severity. The objective of the study is to identify the molecular characteristics of the DENV circulated during 2017 outbreak in Tamil Nadu, India, and to investigate the role of inflammatory cytokines in different "serotypes" and in "dengue severity". A total of 135 suspected samples were tested for DENV infection using IgM, IgG, and qPCR assay; where 76 samples were positive for DENV and analyzed for 12 inflammatory cytokines using ELISA. Serotyping shows 14 DENV-1, 22 DENV-2, 7 DENV-3, and 33 DENV-4, where DENV-4 was predominant. Among 76, 42 isolates were successfully sequenced for C-prM region and grouped. A lineage shift was observed in DENV-4 genotype. Irrespective of serotypes, IFNγ was significantly elevated in all serotypes than control as well as in primary infection than secondary, indicating its role in immune response. GM-CSF and IP-10 were significantly elevated in secondary infection and could be used as prognostic biomarkers for secondary infection. Our observation shows differential cytokine expression profile varied with each serotype, indicating serotype/genotype-specific viral proteins might play a major role in dengue severity. DENV-4 as dominant serotype was reported in Tamil Nadu for the first time during an outbreak with a mixed Th1/Th17 cytokine expression profile that correlated with disease severity. We conclude it is essential to identify circulating viral genotype and their fitness by mutational analysis to correlate with disease severity and immune status, as this correlation will be helpful in diagnostics and therapeutics applications. [ABSTRACT FROM AUTHOR]

• Generated data on bacterial meningitis burden among under-five children in India. • S. pneumoniae the commonest etiology with high proportion of MDR strains. • Two-thirds of pneumococcal serotypes covered by PCV13. • Continued surveillance needed to assess the impact of PCV following introduction. A hospital-based sentinel surveillance network for bacterial meningitis was established in India to estimate the burden of bacterial meningitis, and the proportion of major vaccine-preventable causative organisms. This report summarises the findings of the surveillance conducted between March 2012, and September 2016 in eleven hospitals. We enrolled eligible children with bacterial meningitis in the age group of one to 59 months. CSF samples were collected and processed for biochemistry, culture, latex agglutination, and real-time PCR. Pneumococcal isolates were serotyped and tested for antimicrobial susceptibility. Among 12 941 enrolled suspected meningitis cases, 586 (4.5%) were laboratory confirmed. S. pneumoniae (74.2%) was the most commonly detected pathogen, followed by H. influenzae (22.2%), and N. meningitidis (3.6%). Overall 58.1% of confirmed bacterial meningitis cases were children aged between one, and 11 months. H. influenzae meningitis cases had a high (12.3%) case fatality rate. The serotypes covered in PCV13 caused 72% pneumococcal infections, and the most common serotypes were 14 (18.3%), 6B (12.7%) and 19F (9.9%). Non-susceptibility to penicillin was 57%. Forty-five (43.7%) isolates exhibited multidrug resistance, of which 37 were PCV13 serotype isolates. The results are representative of the burden of bacterial meningitis among under-five children in India. The findings were useful in rolling out PCV in the National Immunization Program. The non-susceptibility to penicillin and multidrug resistance was an important observation. Timely expansion of PCV across India will significantly reduce the burden of antimicrobial resistance. Continued surveillance is needed to understand the trend after PCV expansion in India. [ABSTRACT FROM AUTHOR]

Dengue virus infection is estimated to cause infection in approximately 390 million people globally each year, of which 96 million develop clinical disease. Dengue serotype 2 (DEN‐2) is the most prevalent serotype over the past 50 years in India, but serotypes 3 and 4 have appeared in some epidemics as well. A retrospective study was conducted in a teaching hospital, western India, between January 2014 and December 2018. The records of dengue serological test were analyzed. In total, 40 randomly selected nonstructural protein 1 (NS1) antigen‐positive samples were analyzed by a reverse transcription‐polymerase chain reaction. The demographic data, that is, age and sex, along with geographic location and platelet count level, were recorded from the Serology laboratory register and Hospital Information System. In total, 14.85% (735/4948) samples tested positive for dengue serology. Most of the laboratory‐confirmed dengue cases, 34.97% (257/735), were observed in the 21–30 years of age group. The most common serotype detected in the tested samples was DEN‐3 in 55% cases (22/40, 13 monoinfection and 9 coinfection with DEN‐1 and DEN‐2). The present study gives an insight into the trend of dengue seropositivity among suspected cases in the western part of Rajasthan, India. This study showed a higher seroprevalence of dengue infection as well as a gradual increase in the seroprevalence in this part of India. [ABSTRACT FROM AUTHOR]

Background and Aim: Listeria monocytogenes is a ubiquitous, intracellular pathogen which has been implicated as a cause of several foodborne outbreaks. This study aimed to generate information on the prevalence and antibiotic resistance profile of Listeria species isolated from seafood. Materials and Methods: A total of 400 samples of fresh fish, 100 samples of dry fish and 200 samples each of crustaceans and mollusks were collected from the fish catchment areas. All the samples were subjected to isolation and identification of Listeria spp. by two-step enrichment in UVM broth and plating on selective agar media (PALCAM) and then subjected to molecular characterization. L. monocytogenes isolates obtained during the study were subjected to serotyping by multiplex polymerase chain reaction. The isolates were also subjected to antibiotic sensitivity test. Results: The prevalence of L. monocytogenes in seafoods in the present study was 0.55%. The isolates of L. monocytogenes were found to possess all virulence genes, namely, iap, hlyA, actA, prfA, plcA, and inlA. All the isolates belonged to serotype 4b. The occurrence of Listeria innocua was found to be more and was detected in 16.77% of seafood samples. Antibiotic sensitivity test revealed that all isolates were resistant to cefixime but were sensitive to almost all other commonly used antibiotics. Conclusion: The presence of Listeria spp. in raw seafood samples augments the need for implementation of good hygienic practices during the handling and processing of seafoods to safeguard the health of the consumers. [ABSTRACT FROM AUTHOR]

Dengue virus (DENV) infection is a major public health concern in India ranging from simple febrile illness to severe outcome. This study aimed to investigate association of serum CRP level and CRP gene polymorphisms towards development of dengue disease susceptibility and severity among eastern Indian patients. Blood was collected from 348 symptomatic patients. Sera was subjected to serological diagnosis for the presence of anti-dengue IgM, anti-dengue IgG antibodies and dengue NS1 antigen by ELISA. Viral RNA was extracted and the presence of DENV genome, viral load, serotypes was determined by qRT-PCR. CRP level and polymorphisms were determined by immunoturbidimetry and polymerase chain reaction–restriction fragment length polymorphism, respectively. Statistical analysis was performed by GraphPad-Prism. Among 206 dengue patients, CRP level increased significantly among patients within acute phase, and patients with qRT-PCR/NS1 antigen positivity, high viral load (HVL), secondary infection, and DENV4 and DENV2 infections. rs3091244, TT genotype positively associated with dengue susceptibility (p = 0.03). CT genotype of rs3093059 and TT genotype of rs3091244 were found to correlate with elevated CRP level and development of WHO-defined warning signs. TT genotype of rs3091244 was more prevalent among HVL patients. Thus, these CRP polymorphic variants and CRP concentration might act as potential prognostic biomarkers for predicting disease severity among acute-stage dengue patients. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the difference in pneumococcal carriage, acquisition, antibiotic resistance profiles and serotype distribution, in human immunodeficiency virus (HIV) affected and unaffected families.Methods: A prospective cohort study was conducted in children with and without HIV in West Bengal from March 2012 through August 2014, prior to 13-valent pneumococcal conjugate vaccine (PCV-13) immunization. One thousand four hundred forty one nasopharyngeal swabs were collected and cultured at five-time points from children and their parents for pneumococcal culture, and serotyping by Quellung method.Results: One hundred twenty five HIV infected children and their parents, and 47 HIV uninfected children and their parents participated. Two hundred forty pneumococcal isolates were found. In children under 6 y, the point prevalence of colonization was 31% in children living with HIV (CLH) and 32% in HIV uninfected children (HUC), p = 0.6. The most common vaccine type (VT) serotypes were 6A, 6B and 19A. All isolates from parents and 71% from children in the HIV uninfected cohort were PCV-13 representative, compared to 33% of isolates from CLH and their parents. Acquisition rate in children was 1.77 times that of parents (OR = 1.77, 95%CI: 1.18-2.65). The HIV status of child or parent did not affect acquisition. Isolates from CLH were more frequently resistant to multiple antibiotics (p = 0.02).Conclusions: While the rate of pneumococcal carriage and acquisition did not differ between CLH and HUC, HIV affected families had exposure to a wider range of serotypes including non-vaccine type serotypes and antibiotic resistant serotypes, than HIV unaffected families. [ABSTRACT FROM AUTHOR]

Introduction: Dengue fever is a mosquito-borne disease caused by flavivirus and has clinical presentation varying from being asymptomatic to severe complications (dengue shock syndrome and dengue hemorrhagic fever) depending on the serotype of the virus involved. Cross-protective immunity between the serotypes is lacking, hence the severity of the disease is more if multiple infections occur with two different serotypes. Hence, data on the demographic-specific prevalence of virus serotypes are vital to optimal clinical measures. Aim: The present study aimed to identify the dengue virus serotypes prevalent in the North Karnataka region of India in correlation to the clinical presentation of the disease. Materials and Methods: A prospective study was carried out in a Teaching hospital of North Karnataka, India, from June 2012 to March 2016. One thousand serum samples were tested for NS 1 antigen aIgM and IgG antibodies by enzyme-linked immunosorbent assay (ELISA) method. Samples positive for NS-1 was subjected to reverse transcription polymerase chain reaction (RT-PCR) for the detection of serotypes. Results: Of the 1000 serum sample test 462 serum samples were positive for dengue virus antigen or antibodies. Two hundred and forty-five patients (53.03%) were male and 217 patients (46.96%) were female. Age group of16-–30 years was more affected followed by 31–45 years, over 45 years, and 0–15 years of age group. Maximum number of cases were observed in Bidar city followed by Humnabad, Aurad, Bhalki, and Basavakalyan regions. Malaise was a predominant symptom in dengue virus serotype-3 (DENV-3) (P < 0.05), while headache (P < 0.001), and retro-orbital pain (<0.05) were predominant symptoms in DENV-2. GI symptoms (nausea, abdominal pain, and diarrhea) were significantly common in DENV-2 (P < 0.001). Hepatomegaly was frequently observed in DENV-2 (17.02%), (P < 0.05). A total of 462 samples were positive for either NS-1, IgM, or IgG or in combination. Viral RNA was extracted from 119 samples positive for NS-1 antigen by ELISA. Of the 119 samples tested for serotyping by RT-PCR, 38 belonged to dengue serotype-1 (DENV-1), 46 were of dengue serotype 2 (DENV-2) and 35 belonged to dengue serotype 3 (DENV-3). A change in the earlier serotype 1 and 2 from 2011 to 2013 to the present serotype DENV-2 and DENV-3 was observed and constant presence of DENV-2 in circulation was recorded. Conclusion: Dengue virus serotype 1, 2, and 3 were prevalent in our study population, and severe clinical manifestations were observed in patients suffering from dengue virus serotype 2 and 3. [ABSTRACT FROM AUTHOR]

Cholera is an acute diarrhoeal disease caused by Vibrio cholerae (V.cholerae). Based on antigenic differences of O antigen, O1 serogroup can be divided into three serotypes. In addition, by performing various biochemical reactions, O1 Serogroup can be differentiated into two biotypes. Outbreaks of Cholera occur seasonally. It is associated with monsoon season, warm temperature, heavy rainfall and increased plankton population. Aim: The aim was to determine the trends in resistance pattern and phenotypic Pattern of Vibrio cholerae. Materials and Methods: A retrospective study was conducted during the period from June 2019-December 2019. Culture of Stool specimens were done on different agar media. Biotyping was done by conventional methods. Serotyping and phage typing was also done along with the Antibiotic susceptibility testing. Descriptive analysis was used and presented in terms of percentage. Results: V.cholerae was isolated in 72 patients and they belonged to serogroup O1 and biotype El Tor. The most common serotype was Ogawa. The predominant phage type were T2 by old scheme and T27 by new scheme of phage typing. The maximum number of V. cholerae isolates was seen in the month of November, 2019 followed by October, 2019. Conclusion: The phenotypic pattern and fluctuating seasonal trend of V. cholerae and antimicrobial resistance encourage the continued epidemiological and microbiological surveillance of the disease. [ABSTRACT FROM AUTHOR]

Introduction: Dengue fever is known to cause outbreaks in urban and semi urban dwellings and rarely in rural areas. The present study investigates an outbreak in remote tribal village of Chhattisgarh in 2015. Dengue virus is found in circulation of the infected patient in the first four days of fever and headache on day fifth after which dengue virus is not detectable in blood. Therefore, we analysed virus isolation and serotyping in serum of patients who presented with 1-4 days of fever. Since dengue IgM begin to appear after four days of symptoms, these samples were not included for RT-PCR. Aim: Isolation and identification of dengue virus serotype from the patients in a dengue fever outbreak in remote tribal village of central India and also to find out the correlation of dengue symptoms with serotype of dengue virus. Materials and Methods: This outbreak affected a population of 7038. Serum samples of clinically suspected patients were tested by dengue NS1 and dengue IgM capture ELISA. Dengue NS1 positive samples were serotyped by reverse transcriptase real time PCR. Results: Out of 746 samples 167 were dengue NS1 positive and 171 were Dengue IgM positive. Twenty six samples were DENV 2 positive, 77 samples were DENV 3 positive and 36 samples were positive for both DENV 2 and DENV 3. There was no correlation between serotype of dengue and severity of symptoms. Conclusion: Surveillance activities and serotyping by RT-PCR of dengue is necessary in the rainy season for prevention and control of dengue in future outbreaks. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study is to know Phage typing and antimicrobial susceptibility pattern of Salmonella species. Methods: A total of 32 Salmonella species isolated from stool and blood specimen were included in the study. They were sent for phage typing to Lady Hardinge Medical College, New Delhi. Antimicrobial susceptibility was done by using Kirby Bauer disc diffusion method. Results: Majority of Salmonella typhi belongs to phage type E1 and biotype I. Decreased susceptibility of the isolate was observed to Ampicillin, Cotrimoxazole, Cephalexin and Gentamicin. Majority of the isolates were sensitive to Ciprofloxacin. Conclusion: Predominant phage type was E1. The antibiotic sensitivity pattern is changing and resistant cases are emerging due to inappropriate use of antibiotics. [ABSTRACT FROM AUTHOR]

Abstract: An outbreak of pasteurellosis with high mortality was recorded in indigenous pigs in India. The presence of Pasturella multocida in samples collected from dead pigs was detected by smear examination and isolation, and later by P. multocida specific polymerase chain reaction (PM-PCR). P. multocida was detected in all the samples collected from dead pigs, with nine strains ultimately isolated. All the isolates were positive by PM-PCR. Six isolates showed CAPA and three were of CAPD capsular types. All the isolates were negative for toxigenic gene (toxA). The isolates were sensitive to oxytetracycline, doxycycline, gentamycin, erythromycin, ampicillin, amoxycillin, chloramphenicol and enrofloxacin and resistant to sulphadiazine and cloxacillin. The PCR assays used in this study have been shown to be useful diagnostic tools for P. multocida detection and characterization. [Copyright &y& Elsevier]

The growing incidence of dengue outbreaks in the state of Karnataka prompted us to study the circulating dengue virus (DENV) and their proportion among the suspected cases of dengue patients during the disease outbreak at Mysuru district of Southern India. The presence of the DENV in a patient's serum sample was identified by RT-PCR using previously published primer pairs targeting CprM gene. DENV serotyping was carried out by semi-nested multiplex PCR using serotype-specific primers and nucleotide sequencing. Three hundred fifty-five samples of serum from suspected dengue cases were collected, and 203 samples (57.18%) were found positives. In 2016, DENV-4 (97.87%) was found to be the most dominant DENV serotype either alone or as co-infection, followed by DENV-2 (8.51%) and DENV-3 (4.25%). In 47 positive cases, co-infection with more than one serotype was detected in 4 cases (8.51%). The analysis of the dengue cases in 2017, DENV-4 was dominating serotype (33.97%), followed by the emergence of DENV-2 (32.05%), DENV-3 (25.64%), and DENV-1 (25.00%). Our study also reports the circulation of all four DENV serotypes in the Mysuru district of Southern India, with concurrent infections rate of 16.66% in 2017. The present study provides information regarding the genetic variation among the circulating DENV serotype in an Indian state of Karnataka. The need for the studying genetic diversity of DENV will be useful during the continuous monitoring for disease burden as well as the development of appropriate prophylactic measures to control the spread of dengue infection. • Emergence of DENV-4 as the predominant serotype during the outbreak of 2016–2017 in Karnataka, South India • Co-circulation of all four dengue virus serotypes during the outbreak • Reports for the presence of Asian genotype of DENV-1 in Karnataka, South India • Provides information regarding the genetic variation among the circulating dengue virus serotypes in Karnataka [ABSTRACT FROM AUTHOR]

Among infectious diseases, Infectious coryza is one of the major problems affecting commercial poultry industry in the developing country like India. It is an upper respiratory tract disease of chickens caused by Haemophilus paragallinarum. The economic impact of the disease is mainly due to increased number of culls and significant reduction (10 to 40 %) in egg production, especially on multi-age farms (Blackall et al., 1997). The research work on infectious coryza so far in India is so scanty that does not provides necessary impact analysis of the disease on the commercial poultry rearers in the country. This paper presents an overview of the occurrence of the disease in India and other countries. The paper compares the economic losses to the poultry owners due to the disease in developed and developing countries. [ABSTRACT FROM AUTHOR]

Background: Dengue fever (DF) is caused by an arthropod-borne dengue virus (DENV), has four serotypes and several genotypes. Although having clinical and epidemiological significance, the information on the circulating serotypes/genotypes is scarce in India., Materials and Methods: Blood specimens were collected from the patients suspected of DF and they are tested for DENV NS1 antigen and DENV IgM by ELISA. Antigen-positive samples were further serotyped by reverse transcriptase polymerase chain reaction. Representative samples from each serotype were sequenced to identify the genotypes., Results: All the four DENV serotypes were detected with the pre-dominance of DENV-1 (n = 49; 41.9%). Cases with multiple DENV serotype infections were also identified. Genotyping showed that DENV-1 belonging to genotype I, DENV-2 cosmopolitan (IV), DENV-3 genotype III and DENV-4 genotype I were active in the circulation during the outbreak in 2017., Conclusion: Our study documents the molecular characteristics of DENV circulating in our geographical locality. The detection of heterologous DENV serotypes highlights the importance of regular molecular monitoring for the early recognition of any switch in pre-dominant serotype., Competing Interests: None

Background Dengue is the most widespread arboviral disease globally. Serotyping of dengue viruses and their genotyping is important in tracing the epidemiology of the disease, monitoring trends and anticipating the possibility of outbreaks in a community. Methods This study is a retrospective analysis, based on data from a tertiary care center from Delhi, India and their correlation with reported literature on circulation and outbreaks of dengue in this region of north India since 1996, when the first virus isolation confirmed outbreak of dengue was reported by our virology laboratory (an Apex Laboratory of the National Vector Borne Disease Control Program, Government of India).Circulating serotypes of DENV were detected and identified from serum samples of suspected dengue patients with fever of 5 days duration or less, by virus isolation in cell culture and/or by real-time or conventional reverse transcription polymerase chain reaction (PCR). Representative serum samples of patients with suspected dengue with duration of fever <5 days were inoculated onto the C6/36 clone of Aedes albopictus cells, and the isolates were identified by indirect immunofluorescence using serotype-specific monoclonal antibodies. Sequencing was done for representative strains as required. Results The predominant serotypes identified were DENV 2 (1996), followed temporally by DENV 1 (1997–2002), DENV 3 (2003–2007), DENV 1 (2008–2012), DENV 2 (2013–2015), and DENV 3 (2016–2018). In 2003, Delhi became hyper-endemic for dengue, with all dengue serotypes co-circulating. Predominant serotypes continued to circulate for 3–6 years. Outbreaks occurred either in the year a serotype was re-introduced after a gap of a few years to become the predominant serotype, or in the following year; except in 2015, when there was a genotypic lineage change in a DENV 2 serotype which had been predominant since 2 years prior to the outbreak year. Conclusion Re-introduction of a dengue serotype which was out of circulation for a few years can precipitate an outbreak. Analysis of temporal patterns and close monitoring of circulating virus strains, particularly at either end of the transmission season, may help in early prediction of the trend for a given year, providing an opportunity to put in place control measures well in time. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Background Typhoid is a leading cause of fever in returning travelers, particularly those visiting friends and relatives in the Indian subcontinent. We reviewed a cohort of patients with enteric fever from our hospitals in North West London, which serves a large Indian resident population. Methods Retrospective analysis of electronic laboratory, microbiology and medical records of all patients with blood cultures positive for Salmonella enterica serotypes typhi (S. typhi) or paratyphi (S. paratyphi) A, B and C from January 1, 2016 to December 31, 2018 at London North West University Healthcare NHS Trust. Organisms were cultured on selective media and identified by API 20E (BioMerieux) or MALDI TOF MS (Bruker). Results 37 blood cultures positive for S. typhi were identified from 26 patients and 37 blood cultures positive for S. paratyphi were identified from 23 patients. The median age was 28 years (range 1–79 years). Infection was more common in males (27/49, 55%) compared with females (22/49, 45%) but this was not statistically significant. Most patients (31/49) had traveled to India. Travel history was not identified for 9 patients. Laboratory results at presentation were available for all patients. Lymphopenia (defined as <1.5 × 109/L) was found in 12/23 (52%) patients with S. paratyphi compared with 10/26 (38%) of those with S. typhi. Thrombocytopenia (defined as <150 × 109/L) was found equally in both groups (22% in S. paratyphi , 27% in S. typhi). Raised alanine transferase (ALT) (defined as >35 IU/L) was seen in 14/23 (61%) in S. paratyphi compared with 19/26 (73%) in S. typhi. Median platelet count was similar in both groups (199 × 109/L in S. paratyphi , 202 × 109/L in S. typhi). Absolute eosinopenia was seen in all patients, consistent with other observational studies. For 3 patients, antibiotic sensitivities were not available. Regarding S. paratyphi cases, 16/21 (76%) were resistant to ciprofloxacin compared with 20/25 (80%) in S. typhi. Azithromycin resistance was seen in 5/46 (11%). All isolates were susceptible to third-generation cephalosporins. Conclusion There is a high rate of ciprofloxacin resistance in this cohort of patients with enteric fever, confirming that the use of third-generation cephalosporins and macrolides in travelers to India is most appropriate for treatment. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Background Leptospirosis is the most widespread zoonotic disease in the world. In India, it is endemic in coast lined states. Renal failure is a severe complication with mortality approaching 22%, early recognition of which helps clinicians in acting fast. This study aimed to investigate the predictors of Acute Kidney Injury (AKI) in Leptospirosis Methods This is a prospective, case–control study done in a tertiary care center in Southern India carried out between October 2017 and December 2018. Patients with confirmed Leptospirosis as per CDC 2013 and Faine's criteria (2012) having AKI as per KDIGO criteria were defined as cases. Subjects without AKI were controls. Demographic, clinical and laboratory data were compared between the groups and analyzed. Logistic regression was performed to analyze the possible risk factors associated with AKI in Leptospirosis. Results A total of 329 subjects met the inclusion criteria of the study. 187 patients with AKI (CASES) and 142 patients without AKI (CONTROLS) were studied. Patients with AKI were older, (mean age- 46.99 ± 13.21 vs. 42.99 ± 15.15 years) had longer hospital stay (9.04 ± 5.62 vs. 6.27 ± 3.27 days) had higher SOFA (7.97 ±2.9 vs. 3.37 ± 2.6) and APACHE 2 scores (14.37±5.93 vs. 4.66 ± 4.4), lower mean arterial pressure (84.01 ± 14.45 vs. 89.01 ± 10.63 mmHg; P = 0.001) lower serum bicarbonate level (21.70 ± 2.35 vs. 18.73 ± 3.78 mEq/dL; P < 0.001). Factors like serum lactate, AST, ALT had no significant difference between the groups. Serovar identification was done in 88 patients, of which 57 had AKI. Australis (16.7%), Pyrogenes (16.7%) and Grippotyphosa (11.1%) were the commonest serovars isolated. Serovar most commonly associated with AKI was Pyrogenes (17.5%) Predictors for AKI were jaundice (P = 0.01, OR 2.25; CI 1.21 –3.26), vomiting (P = 0.017, OR 1.9, CI 1.12- 3.26) Hypotension (P = 0.02, OR = 12.3, CI 1.85 – 107.2), tachypnea (P = 0.006, OR = 2.55, CI 1.11- 3.24), leukocytosis (P < 0.001, OR 5.45, CI 1.86- 4.89), thrombocytopenia (P < 0.001, OR 6.49, CI 2.33 – 6.75) Conclusion Identification of features like hypotension, tachypnea, acidosis, leukocytosis, thrombocytopenia, the occurrence of serovar Pyrogenes should alert the clinician on risk of developing AKI Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Dengue is a rapidly spreading acute arboviral infection transmitted through a human and Aedes mosquito cycle. Though northeast region of India has been experiencing dengue outbreaks regularly for over a decade, reports on genetic characterization of the virus from this region are limited. The present study was undertaken to detect the genotype and genetic composition of circulating dengue virus (DENV) in this region. Blood samples were collected from 918 suspected dengue patients of five northeast Indian states. Serological investigations, viz, nonstructural 1 (NS1) enzyme-linked immunosorbent assay (ELISA), immunoglobulin M (IgM) ELISA, and immunoglobulin G (IgG) ELISA were performed followed by molecular detection. Sequence analysis and phylogenetic tree construction based on capsid-premembrane (C-prM) gene junction was done by BioEdit and MEGA6 software, respectively. Serological detection showed 35.34% NS1 and 18.12% IgM positivity. Secondary infection was observed in 24.53%. All four serotypes were detected. Phylogenetic analysis demonstrated circulation of genotype III of DENV-1, genotype IV of DENV-2, and genotype III of DENV-3. Sequences from this region form distinct clades in the phylogenetic tree. Characterization of the C-prM gene junction reveals divergence among the DENV strains. As genetic variation within the DENV is known to be associated with diverse clinical outcomes, information regarding the genetic composition of circulating virus could be beneficial in designing an effective intervention strategy., (© 2019 Wiley Periodicals, Inc.)

Competing Interests: None

Background: Dengue is one of the most important and widespread viral infection comprises 4 related serotypes (DEN-1, 2, 3, and 4). Infection with one serotype does not protect against the others, and sequential infections put people at greater risk for dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). This study determines the epidemiology of prevailing viral infections with dengue and molecular characterization of serotype-specific DENV circulation in Odisha of eastern India., Methods: During the year 2013, 1980 blood samples with suspected dengue cases were obtained between days 1-10 of illness and analyzed by NS1 Ag-RDT, NS1 Ag-ELISA, and RT-PCR. The differential detection of dengue infections and DENV serotyping were carried out by IgM/IgG Ab-ELISA and RT-PCR, respectively., Results: Of the 1980 samples, 733 (37.0%) were positive for dengue RNA by RT-PCR. The confirmed cases of dengue were more in males (73.6%) in comparing to females (26.4%). The age group of 15-44years (527 cases, 71.9%) were more susceptible to dengue infections. 656 (89.5%) cases had infected with monotypic infection by different DENV serotype and 77 (10.5%) cases had multitypic infections by multiple serotypes of DENV. Of the total multitypic infections, there were 74 (10.1%) cases had infected with DENV-2 and DENV-3 serotypes at a time; and only 3 (0.4%) cases had the concurrent infections of all three serotypes that were, DENV-1, DENV-2, and DENV-3. Of the 28 DHF cases, there were 17 (2.3%) cases had infected with multitypic infections and 11 (1.5%) cases had infected with monotypic infection., Conclusion: Dengue infections have prevailed from the month of July and grasped it's the peak in September. Rain, temperature and relative humidity have favored the dengue infections. Young adults and males are more susceptible to dengue infections. Serotypes DEN-2 followed by DEN-3 was dominant among the confirmed dengue cases. Co-circulation of multitypic infections with multiple DENV serotypes and the emergence of DHF cases suggested that eastern Indian state Odisha was becoming a hyper-endemic province for dengue; therefore, continuous surveillance is suggested for understanding the epidemiology of the diseases and monitoring the changes in the characteristics of circulating DENV strains., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objectives: Neisseria meningitidis is an important causative agent of meningitis and/or sepsis with high morbidity and mortality. Baseline genome data on N. meningitidis, especially from developing countries such as India, are lacking. This study aimed to investigate the whole genome sequences of N. meningitidis isolates from a tertiary care centre in India., Methods: Whole-genome sequencing was performed using an Ion Torrent™ Personal Genome Machine™ (PGM) with 400-bp chemistry. Data were assembled de novo using SPAdes Genome Assembler v.5.0.0.0. Sequence annotation was performed through PATRIC, RAST and the NCBI PGAAP server. Downstream analysis of the isolates was performed using the Center for Genomic Epidemiology databases for antimicrobial resistance genes and sequence types. Virulence factors and CRISPR were analysed using the PubMLST database and CRISPRFinder, respectively., Results: This study reports the whole genome shotgun sequences of eight N. meningitidis isolates from bloodstream infections. The genome data revealed two novel sequence types (ST12777 and ST12778), along with ST11, ST437 and ST6928. The virulence profile of the isolates matched their sequence types. All isolates were negative for plasmid-mediated resistance genes., Conclusions: To the best of our knowledge, this is the first report of ST11 and ST437 N. meningitidis isolates in India along with two novel sequence types (ST12777 and ST12778). These results indicate that the sequence types circulating in India are diverse and require continuous monitoring. Further studies strengthening the genome data on N. meningitidis are required to understand the prevalence, spread, exact resistance and virulence mechanisms along with serotypes., (Copyright © 2017 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.)

Background: The virulence of Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) in any individual depends on the type of strain of this bacterium. To our knowledge, there have been no studies reported in Indian subjects about A. actinomycetemcomitans serotype occurrence, co-existence with herpes virus and the possible influence of such co-existence on periodontal pathology., Methods: Subjects for this study were a subset of a larger study to identify the prevalence of A. actinomycetemcomitans in chronic periodontitis. A total of 63 subjects (12 periodontally healthy and 51 with chronic periodontitis) who were positive for A. actinomycetemcomitans were serotyped for strain-level identification. The presence of Human Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) was tested in subgingival plaque samples by polymerase chain reaction., Results: All five serotypes a to e were detected. Of the samples analyzed 38.09% harbored a single serotype, 36.5% had two serotypes, 6.3% demonstrated three and 4.7% demonstrated four serotypes. None of the samples showed presence of JP2 strain. Serotypes b, c, and e were most frequently identified in these individuals (46.03%, 36.5% and 38.09% respectively). Presence of serotypes b and c and absence of serotype d was associated with increased PD and CAL. Among 63 samples analyzed, 11 samples had CMV, four samples had EBV and nine samples had both these viruses. The PD and CAL were significantly higher (p = 0.04) when a combination of CMV and one of the serotypes was present indicating a pathological role of the coexistence., Conclusion: Multiple serotypes are associated with chronic periodontitis in Indians, however, JP2 strains are not detectable in this cohort. Presence of multiple serotypes and a combination of any serotype with herpesvirus is associated with greater severity of the disease., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Dengue fever, a mosquito-borne viral disease, has become a major public health problem with marked expansion in recent decades. Dengue has now become hyperendemic in India with co-circulation of all the four serotypes. Herein, we report an unprecedented outbreak which occurred during August to October 2011 in Odisha, eastern India. This is the first report of a large epidemic in Odisha. Detailed serological and molecular investigation was carried out to identify the aetiology. Almost half of the samples were found to be dengue antigen (NS1) positive. Further molecular assays revealed circulation of mixed dengue serotypes (DENV-2 and DENV-3). Cosmopolitan genotype of DENV-2 and -3 were identified as the aetiology by phylogenetic analysis. Interestingly, a new lineage of DENV-3 within cosmopolitan genotype was incriminated in this outbreak. The emergence of the unprecedented magnitude of the dengue outbreak with the involvement of a novel lineage of DENV in a newer state of India is a major cause for concern. There is an urgent need to monitor phylodynamics of dengue viruses in other endemic areas.

Abstract: Of the estimated half-million deaths from rotavirus globally each year, approximately one-third (N =160,000 deaths) occur in the Indian subcontinent (defined as India, Bangladesh, and Pakistan). Two commercial vaccines are available for use and recommended by WHO, although the prohibitive vaccine price has limited their introduction into routine childhood immunization programs. New rotavirus vaccines are in late clinical development, including two advanced candidates in India. As significant shifts in rotavirus strain diversity have occurred in the past three decades and questions remain regarding whether strain replacement may occur following introduction of rotavirus vaccines, it is important to understand the temporal and regional strain diversity profile before vaccine introduction. We reviewed 33 peer-reviewed manuscripts from the Indian subcontinent and found that the most common G-types (G1–4) and P-types (P[4] and P[8]) globally accounted for three-fourths of all strains in the subcontinent. However, strains varied by region, and temporal analysis showed the decline of G3 and G4 in recent years and the emergence of G9 and G12. Our findings underscore the large diversity of rotavirus strains in the Indian subcontinent and highlight the need to conduct surveillance on a regional scale to better understand strain diversity before and after rotavirus vaccine introduction. [Copyright &y& Elsevier]