Journal of Gastrointestinal Infections

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2019 | January-December | Volume 9 | Issue 1


Vishwa M Katoch

Reprioritizing Research-cum-intervention Strategies on Gastrointestinal Infections Considering Swachh Bharat Abhiyan

[Year:2019] [Month:January-December] [Volume:9] [Number:1] [Pages:4] [Pages No:1 - 4]

Keywords: Implementation, Sanitation revolution, Swachh Bharat Abhiyan, Swachh Bharat Mission

   DOI: 10.5005/jp-journals-10068-3033  |  Open Access |  How to cite  | 

Original Article

Supriya Mahajan, Juhi Khurana, Archana Rastogi, Ekta Gupta

Association between Helicobacter pylori Infection and Nonalcoholic Fatty Liver Disease

[Year:2019] [Month:January-December] [Volume:9] [Number:1] [Pages:5] [Pages No:5 - 9]

Keywords: ELISA, Helicobacter pylori, IgA, IgG, IgM, NAFLD, NAS, NASH

   DOI: 10.5005/jp-journals-10068-3025  |  Open Access |  How to cite  | 


Background: The role of Helicobacter pylori in extragastrointestinal diseases, though not clearly established, is of great importance. Objectives: The study aims to evaluate the role of H. pylori infection in nonalcoholic fatty liver disease (NAFLD) and its association with NAFLD severity. Materials and methods: Thirty-six patients with biopsy-proven NAFLD (17 patients with simple nonalcoholic fatty liver and 19 patients with nonalcoholic steatohepatitis—NASH) and 23 healthy blood donors (control group) were included in the study. Serum samples were tested for H. pylori antibodies IgG, IgM, and IgA using enzyme-linked immunosorbent assay (ELISA). Parameters associated with metabolic syndrome were compared between H. pylori seropositive and seronegative patients in the NAFLD group. Seroprevalence and antibody titers of H. pylori in the NAFLD group were compared with the control group. Results: Anti-H. pylori IgG was positive in 22 (61%) cases of the NAFLD group and 13 (56%) cases of the control group. Anti-H. pylori IgM was positive in 4 (11%) cases of the NAFLD group and 2 (8%) cases of the control group. Anti-H. pylori IgA seroprevalence in the NAFLD group (n = 11; 31%) was higher than the control group (n = 4; 17%; p = 0.03). The NAFLD group had a higher anti-H. pylori IgA titer than the control group (p = 0.03). There were similar rates of anti-H. pylori IgG/IgM/IgA titers between NAFLD and NASH patients with no significant correlation between H. pylori infection and metabolic syndrome. Conclusion: An association of H. pylori infection was seen in NAFLD cases which might have a role in the pathogenesis of fatty liver diseases. This can be further explored for its exact role in the causation of fatty liver disease.

Original Article

Anusha Hoskere Chandrashekhara, Sohan R Bangera, Vignesh Shetty, Suganthi M Devadas, Poornima Bhagavath, Mamatha Ballal

A Study on the Physicochemical and Bacteriological Analysis of Sewage Water from Coastal Karnataka, India

[Year:2019] [Month:January-December] [Volume:9] [Number:1] [Pages:5] [Pages No:10 - 14]

Keywords: Antimicrobial resistance, Bacterial isolation, Chloride, Hardness of water, pH value, Sewage water

   DOI: 10.5005/jp-journals-10068-3027  |  Open Access |  How to cite  | 


Background and objectives: Water, the elixir of life, gets polluted by fecal contaminants, household wastes, and industrial effluents into sewage water and acts as a vehicle in the transmission of human diseases associated with microorganisms. The present study was carried out to isolate and identify the pathogenic microorganisms along with their antimicrobial resistance pattern and also to chemically analyze the sewage water sources of Udupi district. Materials and methods: The 12 sewage water samples were collected from different localities and subjected to bacterial isolation, identification, and antimicrobial susceptibility testing (AST). The chemical analysis of pH value, total hardness, and amount of chloride present in the samples was determined. Results: A total of 26 organisms were isolated which consisted of waterborne pathogens, Vibrio alginolyticus (V. alginolyticus) (n = 2) and Aeromonas sobria (A. sobria) (n = 2) along with the environmental pathogens (n = 22). A. sobria showed resistance to cefotaxime and the other isolates were susceptible to the antimicrobial drug tested. The pH ranged from 5.7 to 7.5. Ten samples were considered as hard, and in two samples, the chloride content was above normal. Conclusion: Contamination of groundwater with the sewage water poses a threat to human health. Hence, treating the sewage water in an appropriate sewage treatment plant (STP) is recommended and the need of the hour.

Original Article

Praveen P. Balgir, Suman Rani

In Silico Analysis of CRISPR-Cas-mediated Bacteriophage Resistance in Lactobacilli

[Year:2019] [Month:January-December] [Volume:9] [Number:1] [Pages:8] [Pages No:15 - 22]

Keywords: Bacteriophages, Clustered regularly interspaced short palindromic repeats, Clustered regularly interspaced short palindromic repeats associated sequences, Lactobacillus, Spacer

   DOI: 10.5005/jp-journals-10068-3031  |  Open Access |  How to cite  | 


Background and objectives: Recent advances in clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR associated sequences (Cas) technology has opened up immense possibilities for improving the gut health and overall immunity of the individual. In development of all these applications, lactic acid bacteria (LAB), which are already a part of human diet, are an attractive vehicle. The technology can utilize the evolutionary perspective of bacterial resistance to phages by this class of bacteria. Thus, the knowledge of CRISPR-based phage resistance in starter cultures is of interest to clinicians as well as food technologists. In the present study, an attempt has been made to explore the presence of CRISPR loci and cas gene clusters in the genomes of Lactobacilli strains available in public databases. A further analysis has been undertaken to identify the spacers left behind by the bacteriophages encountered by Lactobacilli during their evolution. Materials and methods: A total of 174 completed and draft genomes of Lactobacilli strains were analyzed by different online tools like CRISPR-Cas finder and CRISPR-Cas++. Results: Different types of the CRISPR-Cas system found in 58 genomes out of 174 genomes were analyzed. No CRISPR sequences were found in 109 genomes. The analysis yielded type I and type II CRISPR-Cas system in 14 genomes each and type III in 1 genome. The study found 32 bacteriophage spacers in different bacterial genomes that predict the identity of phages infecting the bacterium over its evolutionary history. Interpretation and conclusion: This study is an exploratory one that has predicted the presence of CRISPRs and their diversity across Lactobacillus species.

Original Article

Veenu Gupta, Neha Mittal

Seroprevalence and Trends of Enterally Transmitted Hepatitis Viruses in a Tertiary Care Hospital: A 3-year Study

[Year:2019] [Month:January-December] [Volume:9] [Number:1] [Pages:5] [Pages No:23 - 27]

Keywords: Hepatitis A virus, Hepatitis E virus, Prevalence, Viral hepatitis

   DOI: 10.5005/jp-journals-10068-3032  |  Open Access |  How to cite  | 


Background and objectives: Despite the significant achievements in recent decades to control viral hepatitis worldwide, hepatitis A virus (HAV) and hepatitis E virus (HEV) infections remain a matter of significant public health concern. Both viruses are transmitted primarily by orofecal route and are present higher in communities with poor sanitation. They cause a disease that is indistinguishable without serologic testing. Prevalence of HEV is less frequent even in endemic areas (7.8–45%), compared to HAV infection (up to 100% in low-income countries). The present study was undertaken to investigate the prevalence of HAV and HEV and to study their seasonal variations. Materials and methods: This was a retrospective study over a period of 3 years. Serum samples from patients suspected of viral hepatitis were tested for anti-HAV and anti-HEV immunoglobulin (Ig) M antibodies by enzyme-linked immunosorbent assay (ELISA). Seasonal trends of HAV and HEV were also studied. Results: The overall percentage positivity for HAV and HEV was 15.4% and 13.9% and the prevalence was more in the males. Majority of cases of HAV infection were in the age-group of 11–20 years, whereas HEV infection was predominant in the age-group of 21–30 years. There was a year-wise increasing trend of HAV and HEV seroprevalence. On comparing the seasonal trends, hepatitis A was more during the monsoon (17.6%) and hepatitis E was more during the summer season (15.1%). Conclusion: The prevalence of hepatitis A was more when compared to hepatitis E, and majority of the patients were males.


Infections in Acute Pancreatitis: A Review

[Year:2019] [Month:January-December] [Volume:9] [Number:1] [Pages:10] [Pages No:28 - 37]

Keywords: Diagnosis, Infected pancreatic necrosis, Management, Pancreatic infections

   DOI: 10.5005/jp-journals-10068-3030  |  Open Access |  How to cite  | 


Acute pancreatitis (AP) is an unpredictable disease accounting for more than 50% of all hospital admissions for pancreatic diseases. The disease is generally mild and self-limiting, but about 20% of the patients develop moderate to severe AP with poor prognosis leading to high morbidity and mortality. Recently increased occurrence of AP has been noted with severe AP requiring several weeks to months for treatment. Acute pancreatitis may get complicated by pancreatic and/or peripancreatic necrosis, which may become infected through several routes. The pathogenesis of secondary bacterial pancreatic infection is still under controversy. Acute pancreatitis is the setting for most infections of the pancreas, which can complicate various stages of pancreatitis. In some patients, AP develops into necrotizing pancreatitis. Patients with AP-related infected pancreatic necrosis (IPN) are prone to develop organ failure, leading to increased mortality, further complicated by multidrug-resistant (MDR) microorganisms. The bacterial spectrum in IPN reflects the commensal flora of the intestine. Clinically, there are no reliable parameters to distinguish infected from sterile necrosis as the clinical features are indistinguishable from other infectious conditions. Infected pancreatic necrosis can be diagnosed mainly by laboratory methods like culture and radiographic scan. The management of AP has developed considerably during the past decades. The preferred choices are primary conservative and minimally invasive modalities compared to open surgical necrosectomy. Antibiotics are generally not given to patients with severe AP because of limited clinical benefits. Various aspects of infections of AP inclusive of diagnostic and management modalities have been reviewed here.


Amrita Kalantri, Pankaj Gupta, Vishal Sharma, Harshal Mandavdhare, Jayanta Samanta, Saroj K Sinha

Hepatic Infections: A Comprehensive Imaging Review

[Year:2019] [Month:January-December] [Volume:9] [Number:1] [Pages:12] [Pages No:38 - 49]

Keywords: Hepatic infections, Hydatid cyst, Imaging, Liver abscess

   DOI: 10.5005/jp-journals-10068-3026  |  Open Access |  How to cite  | 


Hepatic infections are common and represent a heterogeneous group of disorders with varying severity. Patients with clinically suspected hepatic infections often undergo imaging evaluation. Imaging allows confirmation when the findings are typical. However, when the imaging appearances are atypical, imaging in conjunction with clinical and laboratory data allows narrowing the differential diagnoses. Further, image-guided sampling helps confirm diagnosis in certain situations. In this review, we describe the imaging appearance of various hepatic infections.


Gaurav Patel, Nabal K Mishra, Prabhunath , Subhajeet Dey, Tanweer Karim

Pancreatic Mass: Remember Tuberculosis—A Rare Cause of Pancreatic Mass

[Year:2019] [Month:January-December] [Volume:9] [Number:1] [Pages:3] [Pages No:50 - 52]

Keywords: Anti-tubercular medications, Pancreatic mass, Pancreatic tuberculosis

   DOI: 10.5005/jp-journals-10068-3023  |  Open Access |  How to cite  | 


Pancreatic tuberculosis is a rare disease. Patients with pancreatic tuberculosis often present with nonspecific symptoms, such as low-grade fever, weight loss, and abdominal pain, and with or without a history of tuberculosis or pancreatic disease. It is often misdiagnosed due to low index of suspicion and masquerading of its symptoms as more common pancreatic conditions such as pancreatic malignancy. This could result in unnecessary surgery. As this is a treatable disease that does not require surgery, it is imperative to diagnose this condition preoperatively. We report this patient of pancreatic mass presenting as locally advanced pancreatic malignancy, subsequently diagnosed to be pancreatic tuberculosis and successfully managed with anti-tubercular medications.


Selvaraj Stephen, Robinson Smiles

An Unusual Parasite in a Colostomy Wound

[Year:2019] [Month:January-December] [Volume:9] [Number:1] [Pages:2] [Pages No:53 - 54]

Keywords: Ancylostoma duodenale, Colostomy wound, Hookworm

   DOI: 10.5005/jp-journals-10068-3028  |  Open Access |  How to cite  | 


Hookworms are common intestinal nematodes in tropical countries. Two of them are, viz., Ancylostoma duodenale and Necator americanus. Small intestine of man is the normal habitat of adult hookworms. Both the adult worms and eggs are excreted and can be seen in the stool specimens. The presence of adult A. duodenale and the eggs in the colostomy wound of a male patient makes an interesting case report to share with the medical fraternity.


Harjeet Singh, Thakur D Yadav, Ashim Das

Invasive Mucormycosis: An Unusual Cause of Intestinal Gangrene in an Immunocompetent Adult

[Year:2019] [Month:January-December] [Volume:9] [Number:1] [Pages:2] [Pages No:55 - 56]

Keywords: Gangrene, Ileum, Mucorales, Mucormycosis, Perforation

   DOI: 10.5005/jp-journals-10068-3024  |  Open Access |  How to cite  | 


Invasive mucormycosis is an opportunistic fungal infection that commonly involves the rhinocerebral and pulmonary system. We are presenting a rare case of small intestine invasive mucormycosis causing multiple perforations and gangrene in the small intestine. Mucormycosis infection occurred after traumatic perforation peritonitis. Mucormycosis usually occurs in the presence of predisposing conditions like uncontrolled diabetes mellitus, neutropenia, underlying malignancy, or those receiving immunosuppressive agents. Gastrointestinal mucormycosis is uncommon and seldom diagnosed in living patients. In these cases, diagnosis is delayed and the mortality rate is high.

Research News Scan

Anshul Sood

Cephamycins: Treatment Option for Recurrent Clostridioides difficile Infection

[Year:2019] [Month:January-December] [Volume:9] [Number:1] [Pages:2] [Pages No:57 - 58]

   DOI: 10.5005/jp-journals-10068-3029  |  Open Access |  How to cite  | 

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