Kempegowda Institute of Medical Sciences

Streptococcus pneumoniae infections remain a significant public health concern, and understanding the baseline functional antibody titer is vital for enhancing vaccination strategies. However, this has not been comprehensively investigated within healthy adult cohorts in India. To address this gap, we investigated the naturally acquired functional antibody titers against 24 vaccine (PPV23 and PCV13) serotypes in 94 healthy adults aged 18 to 65 by multiplexed opsonophagocytic assay. Of the 24 serotypes examined, 12 had geometric mean titers (GMTs) of opsonization index (OI) < 64. The remaining serotypes showed GMTs ranging from 65 to 100 (8, 19A, and 22F), 100 to 200 (9V, 10A, 11A, and 20B), and over 350 (6B, 9N, 14, 17F, and 33F). Statistical analysis revealed 5 serotypes (9N, 14, 17F, 20B, and 33F) had significantly higher GMTs than others. Additionally, 17 serotypes displayed higher GMTs in females compared to males. These results suggest that while serotype-specific GMTs were within the protective range (≥64 GMTs of OI), over half of the individuals had non-protective OI titers against 14 serotypes (9 PCV13 and 5 non-PCV13). This underscores the need for further investigation of naturally acquired antibody titers with larger sample sizes to determine the necessity of adult pneumococcal immunizations to mitigate the disease burden.

Multiplex PCR analysis of 348 recto-vaginal swabs from non-pregnant women revealed 33 % GBS colonization, with serotype V predominant. The study highlights the utility of multiplex PCR as a rapid and accurate diagnostic tool for detecting and serotyping Group B Streptococci directly from clinical specimens, supporting its role in surveillance, infection control, and guiding vaccine strategies in this underrepresented population.

Background and purpose Non-variceal upper gastrointestinal (GI) bleeding is a potentially life-threatening condition. This study aimed to evaluate clinical outcomes in patients presenting with non-variceal upper GI bleeding who had a prior history of ischemic stroke. Methods The 2021 National Inpatient Sample database was used to identify 259,025 patients diagnosed with non-variceal upper GI bleeding, of whom 1,485 had a documented history of ischemic stroke. Data were analyzed using Stata version 18 (StataCorp LLC, College Station, TX, US) to assess the primary outcome of in-hospital mortality. Secondary outcomes included length of hospital stay, hospitalization cost, and discharge disposition. Results Among the 259,025 admissions for non-variceal upper GI bleeding, 1,485 (0.57%) patients had a prior ischemic stroke. The mean age of these patients was 72.35 years, and they had a higher prevalence of comorbidities. A history of ischemic stroke was associated with significantly increased in-hospital mortality (OR 7.51, p < 0.01), a longer hospital stay by an average of 5.68 days (p < 0.01), and a greater need for discharge to a skilled nursing facility (OR 3.30, p < 0.01). No statistically significant associations were found between race, median income, or geographic region and clinical outcomes. Conclusion Patients with a history of ischemic stroke presenting with non-variceal upper GI bleeding are typically older and have more comorbidities. Prior stroke is an independent risk factor for increased mortality, longer hospitalization, higher healthcare costs, and a greater likelihood of discharge to a nursing facility in this population.