Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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On Sep 2018




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Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
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"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Professor and Head
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Saraswati Dental College
Lucknow
On Sep 2018




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MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




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Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




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"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
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Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Case report
Year : 2022 | Month : April | Volume : 16 | Issue : 4 | Page : DD01 - DD02 Full Version

Chryseobacterium gleum: A Rare Pathogen from Respiratory Tract Infections- A Case Report


Published: April 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/53010.16184
Mohammad Mukhit Abdul Gaffar Kazi, Gayatri S Gurav, Chinmay K Saraf, Mangesh G Bolegave, Sonam D Shinde

1. Associate Professor and Incharge, Department of General Pathology and Microbiology, Sinhgad Dental College and Hospital, Pune, Maharashtra, India. 2. Postgraduate Student, Department of Microbiology, Health Accurate Diagnostic Laboratory, Pune, Maharashtra, India. 3. Director, Department of Pathology, Health Accurate Diagnostic Laboratory, Pune, Maharashtra, India. 4. Director, Department of Pathology, Health Accurate Diagnostic Laboratory, Pune, Maharashtra, India. 5. Undergraduate Student, Department of Microbiology, Health Accurate Diagnostic Laboratory, Pune, Maharashtra, India.

Correspondence Address :
Dr. Mohammad Mukhit Abdul Gaffar Kazi,
Associate Professor and Incharge, Department of General Pathology and Microbiology, Sinhgad Dental College and Hospital, Pune, Maharashtra, India.
E-mail: mukhitkazi@gmail.com

Abstract

It is well known that Hospital Acquired Infections (HAIs) are a major concern in the field of medicine. The newer pathogens have been implicated as one of the causative agents in these infections. Recently our laboratory had reported a rare pathogen from a postoperative case admitted in the tertiary care hospital. The causative agent was a Gram negative bacillus, which was identified as Chryseobacterium gleum by automation method (VITEK 2 Biomeriux). This is a rare bacterium that was isolated from a respiratory specimen of a 32-year-old male who was involved in a road traffic accident. Repetitive culture was done followed by Gram stain and biochemical reactions and identified as Chryseobacterium gleum by automated system. It is interesting to study this bacterium for its virulence, habitat and source of infections. This is the second case report which has been reported as a causative agent in HAI as per our knowledge from India.

Keywords

Endotracheal secretions, Flavobacteirum, Gram negative bacillus, Hospital acquired infections, Non fermenter

Case Report

A 32-year-old male with a history of road traffic accident was operated by craniotomy in a tertiary care hospital. The tracheostomy was done for further management. After 3rd day of the admission, the patient developed a lower respiratory tract infection. An endotracheal secretion was received for aerobic culture and sensitivity. Tracheal aspirate grew dark yellow (golden) coloured non haemolytic colonies on sheep blood agar (EOS Laboratories, Lot No. 210330006) nine (Table/Fig 1) and no growth on MacConkey agar (EOS Laboratories, Lot No. 210406009). The repeat cultivation from the same specimen as well as from the growth on blood agar had shown the similar growth pattern. Identification was done manually by using biochemical tests and Gram staining. However, the Gram stain and biochemical reactions were not suggestive of gram positive cocci but long slender gram negative bacilli. So, an automated identification system from an outsourced laboratory was used for identification. The report came as Chryseobacterium gleum, which was never isolated in our laboratory before from any respiratory specimens. Antibiotic sensitivity was done by Kirby-Bauer disc diffusion method (Table/Fig 2). The patient was put on cotrimoxazole based on the antibiotic sensitivity reported and patient responded well and got discharged from the hospital.

Discussion

Chryseobacterium gleum belongs to the family Flavobacterium. This Gram negative bacterium is non fermentative and is unable to grow on MacConkeys agar. It grows well on sheep blood agar with golden yellow pigmentation. It is implicated mainly in infections such as urinary tract infections and pneumonia (1).

It is found in aqueous environments and is able to form the biofilms which makes it a pathogen in patients with ventilators and in patients with various catheters or intravenous lines, thus playing a role in nosocomial infections (2).

The major concern with this pathogen is their intrinsic resistance shown to drugs like carbapenems and colistin which are ultimate drug choice to treat HAIs (3). This pathogen was reported from various countries including India in last few years (4). In the current case report, authors have described Chryseobacterium gleum from an endotracheal secretion from a male patient who was operated (craniotomy) for further management.

The emergence of Chryseobacterium gleum was first described by the SENTRY study (5), which reported isolates of members of the genus Chryseobacterium to constitute 0.27% of Non Fermenting Gram Negative Bacilli (NFGNB) obtained from clinical specimens across 16 countries. In this study, total 50 isolates (24 Chryseobacterium meningosepticum, 20 Chryseobacterium indologenes, two Chryseobacterium gleum, and four Chryseobacterium spp. isolates) were collected and reported highest prevalence of Chryseobacterium in the elderly patients. They found the most active antimicrobials agents were the newer quinolones (garenoxacin, gatifloxacin, and levofloxacin) followed by rifampin, trimethoprim-sulfamethoxazole, ciprofloxacin, and piperacillin-tazobactam. However, they had reported that vancomycin showed poor potency.

Amongst the different species, Chryseobacterium meningosepticum (now named as Elizabethkingia meningoseptica) was the most frequently isolated from clinical specimens, while Chryseobacterium gleum was the least frequently isolated species, with only two strains isolated over the five year study period. Later, there has been a limited case report of Chryseobacterium gleum published so far from clinical specimens like blood, sputum, and urine and pus (6),(7),(8),(9).

Lo HH and Chang SM in their study revealed that Chryseobacterium gleum had the ability to form biofilms (6). However, its potential of biofilm formation appeared to be much lower than that of Elizabethkingia meningoseptica, suggested lower pathogenic capability of Chryseobacterium gleum. Chryseobacterium gleum was also recovered from bloodstream infections. The isolation of Chryseobacterium gleum from endotracheal secretions has not been documented from India before as per our knowledge. This is the first report from Maharashtra, India as per our knowledge. Interestingly the current strain did not show any growth on MacConkey agar plate, which was also reported by Lambiase A et al., however, study reported by Jain V et al., stated that the strain was able to grow on MacConkey agar (4),(10).

Prolonged hospitalisation with indwelling catheters and the use of broad spectrum antibiotics have been reported to be the risk factors for acquiring infections. Rare isolation of such pathogens from a clinical specimen needs to be given great attention while managing these infections. It is also essential to see that the isolate is a real pathogen and not a coloniser. To rule out between pathogen and coloniser, repeat the cultures with certain frequencies. In index case, the patient responded well to antibiotics prescribed and repeat specimens from the patient was also possible. There are no standard guidelines available in the literature from any statutory institutions for its identification and antibiotic susceptibility testing. The literature has constantly shown Chryseobacterium gleum strains to be largely vulnerable to fluoroquinolones, piperacillin-tazobactam (11).

Looking at very notorious characteristics of this isolate regarding its growth on MacConkey agar and antibiotic sensitivity pattern, it is essential to study this bacterium for growth characteristics, resistance mechanisms to higher antibiotics and the sources of infections.

Conclusion

There is a risk of infection in critically ill patients who had been admitted in Intensive Care Unit (ICU) with prolonged duration and with various devices and catheters due to emerging pathogens like Chryseobacterium gleum. As this pathogen has shown inherent resistance to carbapenems, colistin and polymyxin B, it is essential to identify rapidly and perform antibiotics sensitivity for guiding therapy.

References

1.
Chiu CW, Li MC, Ko WC, Li CW, Chen PL, Chang CM, et al. Clinical impact of Gram-negative non fermenters on adults with community-onset bacteremia in the emergency department. J Microbiol Immunol Infect. 2015;48(1):92-100. [crossref] [PubMed]
2.
Zheng Y, He L, Asiamah TK, Otto M. Colonisation of medical devices by staphylococci. Environ Microbiol. 2018;20(9):3141-53. [crossref] [PubMed]
3.
Holmes B, Owen RJ, Steigerwalt AG, Brenner DJ. Flavobacterium gleum, a new species found in human clinical specimens. International Journal of Systematic Bacteriology. 1984;34(1):21-25. [crossref]
4.
Jain V, Hussain NAFA, Siddiqui T, Sahu C, Ghar M, Prasad KN. Simultaneous isolation of Chryseobacterium gleum from bloodstream and respiratory tract: First case report from India. JMM Case Rep. 2017;4(10):e005122. [crossref] [PubMed] [PubMed]
5.
Kirby JT, Sader HS, Walsh TR, Jones RN. Antimicrobial susceptibility and epidemiology of a worldwide collection of Chryseobacterium spp: Report from the SENTRY antimicrobial surveillance program (1997-2001). J Clin Microbiol. 2004;42(1):445-48. [crossref] [PubMed]
6.
Lo HH, Chang SM. Identification, characterization, and biofilm formation of clinical Chryseobacterium gleum isolates. Diagn Microbiol Infect Dis. 2014;79(3):298-302. [crossref] [PubMed]
7.
Abdulwahab A, Taj-Aldeen SJ, Ibrahim EB, Talaq E, Abu-Madi M, Fotedar R. Discrepancy in MALDI-TOF MS identification of uncommon Gram-negative bacteria from lower respiratory secretions in patients with cystic fibrosis. Infect Drug Resist. 2015;8:83-88. [crossref] [PubMed]
8.
Virok DP, Ãbrók M, Szél, Tajti Z, Mader K, Urbán E, et al. Chryseobacterium gleum- A novel bacterium species detected in neonatal respiratory tract infections. J Matern Fetal Neonatal Med. 2014;27(18):1926-29. [crossref] [PubMed]
9.
Brkić DV, Zlopaša O, Bedenić B, Plečko V. Chryseobacterium gleum infection in patient with extreme malnutrition and hepatic lesion -Case report. Signa Vitae. 2015;10:50-52. [crossref]
10.
Lambiase A, del Pezzo M, Raia V, Sepe A, Ferri P, Rossano F. Chryseobacterium respiratory tract infections in patients with cystic fibrosis. J Infect. 2007;55(6):518-23. [crossref] [PubMed]
11.
Tsouvalas CP, Mousa G, Lee AH, Philip JA, Levine D. Chryseobacterium gleum isolation from respiratory culture following community-Acquired pneumonia. Am J Case Rep. 2020;21:e921172. [crossref]

DOI and Others

DOI: 10.7860/JCDR/2022/53010.16184

Date of Submission: Oct 27, 2021
Date of Peer Review: Dec 26, 2021
Date of Acceptance: Feb 10, 2022
Date of Publishing: Apr 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 27, 2021
• Manual Googling: Feb 08, 2022
• iThenticate Software: Feb 10, 2022 (13%)

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