Carbapenem-resistant Enterobacterales (CRE) infections, which are associated with high morbidity and mortality, are increasingly reported worldwide, particularly in healthcare settings. This observational study investigated patients with CRE infections at an Indian tertiary care hospital. The infections predominantly affected elderly individuals: the 61–80 age group accounted for 59.4% of cases, while the 71–80 subgroup alone comprised 38.6% of patients. Regarding hospital stay duration, nearly half of the patients (48.3%) were hospitalized for 0–10 days, whereas 31.0% remained hospitalized for 31 days or more. The most frequently utilized indwelling devices were Foley catheters, followed by nebulizers, nasogastric (NG) tubes, and ventilators. Microbiologically, Klebsiella pneumoniae was the primary isolate (58.6%), followed by Escherichia coli (27.3%), Pseudomonas aeruginosa (6.1%), Acinetobacter baumannii (2.0%), non-lactose fermenters (2.0%), and Providencia rettgeri, Enterobacter cloacae, and Aspergillus spp. (2.0% each). This study highlights the clinical and microbiological characteristics of CRE isolated from hospitalized patients. Genetic analysis revealed that blaNDM and blaOXA-48 were the most prevalent carbapenemase genes, while blaKPC and blaIMP occurred less frequently. Notably, several isolates co-harbored multiple resistance genes (such as blaNDM and blaOXA-48, suggesting the emergence of multidrug-resistant variants with complex resistance determinants.
S. Naskar, B. Chaudhuri, P. Guchhait et al.· EAS Journal of Parasitology...· 0 citations
Background: Infections of the bloodstream and sepsis are significant causes of morbidity and mortality, especially when complicated by multidrug resistance. Molecular diagnosis represents a tool for rapid identification of causative organisms with subsequent optimization of antimicrobial therapy; however, conventional blood culture still plays a critical role as a reference method for microbial identification and susceptibility testing. Methods: The study included 110 bloodstream isolates obtained from patients with suspected bacteremia and sepsis. Conventional blood culture was used for organism identification, incubation time analysis, and antibiogram testing, while multiplex PCR was used to screen for the most prevalent resistance determinants, namely NDM, OXA-48, KPC, VIM, mecA, and VanA/VanB genes. Bloodstream and non-bloodstream isolates from selected cases of sepsis were compared. Results: Klebsiella pneumoniae: 27 (24.5%), Staphylococcus aureus13 (11.8%), Escherichia coli8 (7.3%), Enterococcus faecium (7; 6.4%), Acinetobacter baumannii (8;7.3%), Enterococcus faecalis (6; 5.5%), and Pseudomonas aeruginosa (6; 5.5%) were the most prevalent species isolated from blood. The majority of cultures became positive within 20 hours from seeding, with 24 out of 97 (24.7%) positive between 0 and 10 hours and 55 out of 97 (56.7%) positive between 11 and 20 hours. The most prevalent resistance determinants were NDM, NDM+OXA-48, mecA, and VanA/VanB. Susceptibility testing revealed that carbapenems were largely ineffective against K.pneumoniae, while aztreonam/avibactam, tigecycline, fosfomycin, linezolid, vancomycin, and teicoplanin showed good activity against several strains of bacteria. Conclusion: The present findings demonstrate the potential utility of multiplex PCR as a rapid assay for detection of multidrug-resistant bloodstream pathogens and early optimization of antimicrobial treatment. At the same time, conventional blood culture remains an indispensable tool fo
Ruparna Kayal, B. Chaudhuri, P. Guchhait et al.· East African Scholars Journa...· 0 citations
Persistent infection with high-risk human papillomavirus (HR-HPV) is the primary driver of cervical cancer; however, viral presence alone is insufficient to induce malignancy. The progression from initial infection to invasive carcinoma requires a coordinated series of alterations in both the viral genome and the host cell's regulatory machinery. This review focuses on three principal mechanisms by which HR-HPV bypasses host regulatory controls: epigenetic modifications, immune evasion, and endocrine signaling. Specifically, we describe how the viral oncoproteins E6 and E7 recruit host DNA methyltransferases—particularly DNMT1, DNMT3A, and DNMT3B—to silence tumor suppressor genes such as CCNA, hTERT, and E-cadherin via promoter hypermethylation. Beyond DNA methylation, HPV disrupts histone acetylation and methylation patterns through interactions with p300/CBP, the NuRD complex, and Polycomb group proteins, while simultaneously dysregulating non-coding RNAs and specific microRNAs to reinforce this transcriptionally silenced state. The review further details how HPV escapes immune clearance by driving a Th1-to-Th2 cytokine shift, downregulating MHC class I expression, and recruiting myeloid-derived suppressor cells and regulatory T cells to the cervical microenvironment. Additionally, we discuss the role of cofactors, focusing on the synergistic interaction between estradiol and HPV oncogenes; this interaction promotes local immunosuppression via estrogen receptor alpha signaling on stromal fibroblasts and infiltrating immune cells. We also examine the contribution of high parity as a key epidemiological risk factor. A comparative analysis of patient data across three distinct studies is presented to illustrate how demographic and reproductive variables correlate with cervical lesion severity in different populations. Ultimately, cervical carcinogenesis stems from multi-pathway interactions where viral oncogenes, epigenetic changes, immune escape, and hormonal factor
Anindita Kundu, B. Chaudhuri, P. Guchhait et al.· East African Scholars Journa...· 0 citations