Learning from an outbreak: ESBL- the essential points

Extended spectrum beta-lactamase (ESBL) producing strains of Klebsiella pneumoniae have emerged as important nosocomial pathogens. The present report describes an outbreak of ESBL positive K. pneumoniae in a neonatal intensive care unit of a tertiary care center in southern India. The clinical and microbiological significance of multiresistant gram negative ESBL producers have been discussed in light of this outbreak by multi-resistant gram negative bacilli. The review also offers some practical guidance regarding infection control and therapeutic options.

Brain abscess due to Cladophialophora bantiana

Cladophialophora bantiana (Xylohypha bantiana) is a dematiaceous fungus with distinct neurotropism. CNS phaeohyphomycosis due to C. bantiana is an uncommon infectious condition and is associated with high mortality. We report this rare clinical entity in a 22-year-old male, presenting as brain abscess. Etiological diagnosis was made based on fungal culture and histopathological examination. Complete surgical resection of the lesion and treatment with antifungal agents could not save the patient from this frequently fatal infection.

Evaluation of lacto-phenol cotton blue (LPCB) for detection of Cryptosporidium, Cyclospora and Isospora in the wet mount preparation of stool

Lacto-phenol cotton blue (LPCB) was found to be a useful stain for detection of Cyclospora and Isospora oocysts in direct wet mounts of stool. LPCB stained these parasites blue, and differentiated their internal structures clearly, thereby facilitating detection and accurate identification of these parasites. However, the LPCB staining was not found useful in the identification of Cryptosporidium. The LPCB wet mount is recommended for use in the laboratories where acid-fast staining is not performed routinely, such as in a peripheral laboratory or in a rural health centre in the developing countries.

Satelliting streptococci in an adult male with foetal heart

Prior to the days of surgical correction and antibiotics, endocarditis was one of the leading causes of death in adults with patent ductus arteriosus (PDA). Satelliting Streptococcus is an important cause of "culture negative endocarditis". There are no earlier reports of this organism causing endocarditis in a case of PDA. Such a unique association, first of its kind, is reported here.