Predominant Isolates Research Articles

Prevalence, Risk Factors and Microbial Profile of Surgical Site Infection after Cesarean Section in a Tertiary Care Center in Western India

Surgical site infection (SSI) was the predominant complication following cesarean delivery. Risk factors like increased Body Mass Index (BMI), emergency cesarean section (CS), prolonged hospital stay, previous CS, anemia, pre-existing chronic diseases, and failure to use preoperative antibiotic prophylaxis associated with SSI. Surgical site infections are responsible for cost burden, longer hospital stay increased maternal morbidity and mortality. Despite the advance, aseptic measures & control practice SSI was the most common nosocomial infection. To determine the prevalence, risk factors, bacterial profile, and antimicrobial resistance pattern of SSI in women following Cesarean section at tertiary care center western India. Women who developed SSI underwent cesarean delivery enrolled in the present study. Data were collected from patient records. Collection of swab samples, identification of microorganisms, and antimicrobial susceptibility testing was done by standard CLSI guidelines Results: Prevalence of SSI was 14.7% in this study. The risk factors significantly associated with SSI were emergency cesarean delivery, severe anemia, lack of preoperative antibiotics use, high Body Mass Index (BMI), preexisting disease, and previous history of CS, Klebsiella Pneumoniae & Staphylococcus aureus was the most predominant isolates. Imipenem was the most susceptible and Amoxycilline-Clavulanate was the most Resistance antibiotic. Prompt identification of risk factors, microbial agents, and susceptibility patterns of SSIs are beneficial for the selection of appropriate antimicrobial therapy to prevent the emergence of drug resistance, planning to make infection control & antibiotic policy, and taking appropriate steps to prevent risk factors.

Evaluation of phenotypic and genotypic patterns of aminoglycoside resistance in the Gram-negative bacteria isolates collected from pediatric and general hospitals

The purpose of the current study was to evaluate the phenotypic and genotypic patterns of aminoglycoside resistance among the Gram-negative bacteria (GNB) isolates collected from pediatric and general hospitals in Iran. A total of 836 clinical isolates of GNB were collected from pediatric and general hospitals from January 2018 to the end of December 2019. The identification of bacterial isolates was performed by conventional biochemical tests. Susceptibility to aminoglycosides was evaluated by the disk diffusion method (DDM). The frequency of genes encoding aminoglycoside-modifying enzymes (AMEs) was screened by the PCR method via specific primers. Among all pediatric and general hospitals, the predominant GNB isolates were Acinetobacter spp. (n = 327) and Escherichia coli (n = 144). However, E. coli (n = 20/144; 13.9%) had the highest frequency in clinical samples collected from pediatrics. The DDM results showed that 64.3% of all GNB were resistant to all of the tested aminoglycoside agents. Acinetobacter spp. and Klebsiella pneumoniae with 93.6%, Pseudomonas aeruginosa with 93.4%, and Enterobacter spp. with 86.5% exhibited very high levels of resistance to gentamicin. Amikacin was the most effective antibiotic against E. coli isolates. In total, the results showed that the aac (6')-Ib gene with 59% had the highest frequency among genes encoding AMEs in GNB. The frequency of the surveyed aminoglycoside-modifying enzyme genes among all GNB was found as follows: aph (3')-VIe (48.7%), aadA15 (38.6%), aph (3')-Ia (31.3%), aph (3')-II (14.4%), and aph (6) (2.6%). The obtained data demonstrated that the phenotypic and genotypic aminoglycoside resistance among GNB was quite high and it is possible that the resistance genes may frequently spread among clinical isolates of GNB.

Prevalence and antimicrobial susceptibility pattern of urinary tract infection among pregnant women attending Hargeisa Group Hospital, Hargeisa, Somaliland

The aim of this study was to determine the prevalence, antimicrobial susceptibility pattern and associated factors of urinary tract infection (UTI) among pregnant women attending Hargeisa Group Hospital (HGH), Hargeisa, Somaliland. A cross-sectional study was conducted at HGH, Hargeisa, Somaliland and participants were selected by systematic random sampling technique. Clean catch midstream urine samples were collected from 422 participants and cultured and antimicrobial susceptibility pattern was determined for the isolates. Univariable and multivariable logistic regression analyses were utilized to identify the independent risk factors for UTI. The prevalence of UTI was 16.4% (95% CI 13.3–19.9). The predominant bacteria isolate was E. coli (43.5%) followed by Coagulase negative staphylococcus (CoNS) 11(16%), S. aureus 9(13%), K. pneumonia 6(8.7%), Pseudomonas aeruginosa 5(7.2%), Proteus mirabilis 4(5.8%), Citrobacter spp 3(4.4%) and M. morganii 1(1.5%) Gram negative bacilli were resistant to ampicillin (96%) and tetracycline (71.4%) and Gram-positive cocci were also resistant to ampicillin (90%), tetracycline (55%). Multidrug resistance was observed in 85.5% of bacterial isolated. No formal education participants, previous history of catheterization and previous history of UTI had 3.18, 3.22 and 3.73 times respectively more likely to develop UTI than their counterparts. Culture and susceptibility test is vital for appropriate management of UTI in the study area.

Post Renal Transplant Infections: A Six Month Follow-Up Study from a Kidney Transplant Institute of North India

Transplantation returns the majority of patients to an improved life-style and an improved life expectancy, as compared to patients on dialysis. Infections are the most prevalent cause of morbidity and mortality in kidney transplant recipients, with more than 80% suffering at least one episode of infection in the first year. The method of data collection in this study was prospective hospital record analysis, all renal transplant recipients were screened pre operatively for the presence of any overt or occult infection. The predominant age group undergoing renal transplantation was between 18 – 29 yrs. Urinary tract infections were the highest and commonest infections observed. The microorganisms involved in the infections were Bacteria (36.4%), Viruses (7.6%), Fungi (3.7%) and Parasites (5.5%). In Urinary tract infection, E. coli followed by Klebsiella pneumoniae were the predominant bacterial isolates. Candida albicans were the commonest fungi isolated. Among the Gastrointestinal tract infections, Cryptosporodium was the commonest Protozoal isolate. Cryptococcus neoformans was isolated in two cases of meningitis. In this study the organisms causing infection during the immediate operative period have been categorized, which will give the treating physician a reasonable idea to suspect the system and cause of infection during the particular post renal transplant period. This study has focused to evaluate the spectrum of infectious complications in post renal recipients in first 6 months of follow up and evaluate the most common type of infection.

Lactic Acid Bacteria Are Prevalent in the Infrabuccal Pockets and Crops of Ants That Prefer Aphid Honeydew.

Ants are evolutionarily successful species and occupy diverse trophic and habitat niches on the earth. To fulfill dietary requirements, ants have established commensalism with both sap-feeding insects and bacteria. In this study, we used high-throughput sequencing of the bacterial 16S rRNA gene to characterize the bacterial composition and structure of the digestive tracts in three species of Formica ants and Lasius niger (Linnaeus)—species that predominantly feed on honeydew secreted by aphids. We found that bacterial communities displayed species- and colony-level signatures, and that bacterial communities in the infrabuccal pockets and crops were different from those in the midguts and hindguts. Lactobacillus and Wolbachia were dominant in the infrabuccal pockets and crops of workers, whereas Wolbachia was dominant in the midguts, hindguts and brood (larvae, pupae and cocoons). To learn more about the dominant Lactobacillus in ants, we assessed its prevalence in a wide range of aphid-tending ants using diagnostic PCR. We found that Lactobacillus was more prevalent in Formicinae than in Myrmicinae species. We also isolated four strains of lactic acid bacteria (Lactobacillus sanfranciscensis, Lactobacillus lindneri, Weissella cibaria and Fructobacillus sp.) from the infrabuccal pockets and crops of aphid-tending ants using a culture-dependent method. Two predominant lactic acid bacterial isolates, Lactobacillus sanfranciscensis (La2) and Weissella cibaria (La3), exhibited abilities in catabolizing sugars (sucrose, trehalose, melezitose and raffinose) known to be constituents of hemipteran honeydew. These findings contribute to further understanding the association between ants, aphids and bacteria, and provide additional information on the function of lactic acid bacteria in ants.

Anaerobes in cardiac infections: A decade experience from the tertiary care center

PurposeAnaerobic infections are common yet life-threatening. They are being recovered from all sites of the body, including the cardiovascular system. This study was aimed to determine the retrospective analysis on the isolation of anaerobes in cardiovascular samples received for a decade-long duration. It helps in knowing the frequency of isolation of anaerobic causes of cardiovascular infection. MethodsAll cardiovascular samples from the department of Cardio-thoracic vascular surgery from January 2010 to December 2020 were studied. ResultsOf 601 samples received, predominant samples were vegetations and valvular tissues of 258, followed by 98 samples of pericardial tissues, 92 samples of embolus, 90 samples of blood and post-operative collections, and 63 excised aneurysms and vascular grafts. Of the total, 15 samples grew anaerobes where Clostridium species were the predominant isolates. Clostridioides difficile was isolated in 2 samples. ConclusionsAnaerobes in cardiovascular samples are uncommon yet form a significant cause of morbidity and mortality. Most infections are from the contiguous spread, penetrating trauma, and hematogenous causing endocarditis or valvular infections. These conditions and samples form the seat of infectious focus and clinical suspicion towards the anaerobic cause of these conditions, especially in conventional routine culture-negative samples. Timely diagnosis of anaerobic infections plays a vital role in the good prognostic outcome of patients undergoing cardiothoracic and vascular surgery.

BACTERIAL AND SENSITIVITY PATTERN OF PATHOGENS CAUSING VENTILATOR-ASSOCIATED PNEUMONIA IN INTENSIVE CARE UNIT

Highlight:1. Antimicrobial resistance bacteria isolated from VAP patients are often associated with high mortality and length of hospital stay. 2. Mortality in VAP patients was 33.3% and the VAP group had a longer hospital stay compared to the non-VAP group. 3. The three most predominant bacteria that were found were A. baumannii, P. aeruginosa, K. pneumoniae. Cefoperazone-sulbactam, meropenem and amikacin were more than 70% sensitive against these bacteria.Abstract:Background: Ventilator-Associated Pneumonia (VAP) is the most common nosocomial infection in Intensive Care Unit (ICU). Antimicrobial resistant bacteria isolated from VAP patients are often associated with high mortality and length of hospital stay. Objective: This study aimed to analyze the pattern and sensitivity among pathogens that caused VAP in ICU. Materials and Methods: The study was conducted retrospectively by extracting the data of bacterial isolates from sputum specimens in the Laboratory of Clinical Microbiology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia and confirming the clinical data on patients suffering from VAP in ICU ward. The study started from January until December 2017. Results: The total 148 pathogens were isolated, 18 of them were diagnosed as VAP, and 130 were not VAP. The most predominant isolates in the VAP group were Acinetobacter baumannii as many as 38 (9%) followed by Pseudomonas aeruginosa 22 (2%), E. coli 16 (7%), and Klebsiella pneumoniae 11 (1%). The pathogens showed a sensitivity rate above 70% to cefoperazone-sulbactam (SCF), meropenem (MEM) and amikacin (AK). Mortality in VAP patients was 33.3% and the VAP group had a longer hospital stay compared to non-VAP group. Conclusion: The three most predominant bacteria that were found were A. baumannii, P. aeruginosa, K. pneumoniae. The pathogens had sensitivity rate above 70% to cefoperazone-sulbactam, meropenem, and amikacin.

Pathogens isolated from bovine clinical mastitis and their antimicrobial resistance

This study aimed to isolate aerobic and microaerophilic bacteria from mastitis milk samples, as well as to determine their antibiotic resistance. A total of 196 bovine mastitis milk samples were tested by standard bacteriological methods and with API identification test kits. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disk diffusion method. The results revealed that the predominant isolate was S. aureus, with an isolation rate of 28%, followed by Streptococcus spp. (27%) and E. coli (19%). Isolation rates for Corynebacterium spp., Mycoplasma spp., and Pseudomonas aeruginosa were 11%, 6%, and 4%, respectively. Compared to the bacteria mentioned above, lower percentages were observed for Trueperella pyogenes (2%), Pasteurella multocida (2%), and Klebsiella pneumoniae (1%). A broad evaluation of antimicrobial resistance showed that the pathogens were resistant to tetracycline (68.63%), oxytetracycline (41.57%), ampicillin (39.08%), ceftiofur (38.1%), cephalexin (32.26%), penicillin (31.25%), amoxicillin/clavulanic acid (24.53%), enrofloxacin (24.44%), gentamycin (23.68%), and trimethoprim/sulfamethoxazole (22.09%). This study demonstrated that the sources of bacteria isolated from mastitis bovine milk samples were both contagious and environmental. More importantly, the present results demonstrate a critically high antimicrobial resistance in dairy cattle. For instance, E. coli isolates showed a crucial resistance to commonly used and recommended antimicrobials, including ceftiofur (100%), cephalexin (83.33%), and tetracycline (94.44%). The results of this study may provide valuable information about clinical aspects of bovine mastitis infections and current antimicrobial resistance levels in dairy cattle.

Bacterial Uropathogens, Antimicrobial Susceptibility Profile and Associated Factors among Pediatric Patients in Bahir Dar, Northwest Ethiopia.

Urinary tract infection (UTI) in the pediatric group may lead to end-stage renal dysfunction later in life. Tracking the type of the isolates and their antimicrobial resistance pattern would impact the management of UTI in these group. The aim of this study was to describe the distribution of bacterial uropathogenes, their antimicrobial susceptibility profile and factors associated with significant bacteriuria (SBU) among pediatric patients at selected facilities in Bahir Dar, Northwest Ethiopia. A cross-sectional study was conducted from 1st February to 30th June 2020. About 5-10ml of urine samples were collected from pediatrics presumptive for UTI and a urine sample was considered positive for SBU if a single organism was grown at a concentration of ≥104cfu/ml. Antimicrobial sensitivity testing was performed using the Kirby-Bauer disc diffusion technique. Logistic regression was used to identify factors associated with SBU and statistical significance was set at p-value < 0.05. Of the total 299 study participants, the majority 173 (57.9%) were females. The mean age of the participants was 6.6 years. The proportion of significant bacteriuria was at 49(16.4%). Most, 37 (75.5%) of the isolates were Gram-negative. The most predominant isolate was E. coli, 21(42.9%) followed by P. aeruginosa, 6(12.2%) and coagulase negative staphylococci, 6(12.2%). The level of multi-drug resistance among Gram-positive and Gram-negatives was at 50% and 78.4%, respectively. Participants' sex, circumcision status, having a flank pain and being malnourished were statistically associated with significant bacteriuria. Actions to minimize antimicrobial resistance should be strengthened to reduce the impact of UTI among the pediatric group.

Identification of Bacterial Agents causing Meningitis in Adult Population using BACTEC FX40 System

Introduction: Bacterial meningitis among adults is a medical emergency and requires immediate diagnosis as well as immediate treatment. As clinical diagnosis is not always reliable, laboratory isolation along with antimicrobial susceptibility results are crucial. Conventional agar culture methods gives poor sensitivity and delayed results. Automated culture methods like BACTEC are suitable option for culture of sterile fluids beside blood culture. Aim: To determine the bacterial agents causing meningitis in this region, along with their antibiogram by using automated culture system BACTEC FX40. Materials and Methods: This cross-sectional, observational study was conducted between October 2019-September 2020 in Department of Microbiology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India. Cereospinal Fluid (CSF) samples received from medicine Intensive Care Unit (ICU) and wards were processed by inoculating them on BD BACTEC Peds Plus/F bottle and then incubating them on BACTEC BD FX40 system. The bottles flagged and positive were subcultured and further processed according to standard laboratory procedures. The antibiotic sensitivity test was performed from isolated organisms by Kirby-Bauer Disc Diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: A total of 108 CSF were received for culture by automated methods from patients suspected of meningitis during the study period. Out of them 84 (77.8%) beeped as positive while 24 (22.2%) were sterile. From the positives, 77 showed growth of gram positive cocci, three were gram negative bacilli and four showed growth of environmental and skin contaminants that were excluded from the study. All gram positive cocci were identified as Staphylococcus aureus (S. aureus). The antibiotic sensitivity testing showed 100% sensitivity to vancomycin and linezolid. Only 25 isolates of S. aureus were sensitive to cefoxitin. Both the isolates of Escherichia coli (E. coli) were sensitive to cefazolin, ceftazidime, aztreonam. Pseudomonas aeruginosa (P. aeruginosa) was sensitive to amikacin and piperacillin/tazobactum. Conclusion: A shift in the trend was observed in the aetiology of bacterial meningitis with Methicillin Resistant Staphylococcus aureus (MRSA) as the most predominant isolate among adult population. BACTEC FX40 system was found more sensitive in detecting pathogens over the conventional methods with reduced time to positivity. Early detection of causative organism will facilitate early initiation of suitable antibiotic therapy, thereby reducing mortality and meningitis associated complications.

Prevalence of Extended Spectrum Beta-lactamase Encoding Genes in Enterobacteriaceae Isolated from Various Clinical Samples in a Tertiary Care Cancer Centre, Kerala, India

Introduction: Cancer patients are disproportionately at high risk of developing infections, with a risk of infection about 10 times than that of non cancer patients. Extended Spectrum Beta-Lactamases (ESBLs) enzyme producing gram-negative bacteria have been marked as one of the “serious” threat by the centre for disease control. This enzyme has the ability to hydrolyse the beta-lactam antibiotics and posses a major threat for the immunocompromised and cancer patients. Hence, understanding its prevalence at the grammatical level is important to decide upon the type of drugs to be prescribed. Aim: To study the prevalence of ESBL genes among the Gram- Negative Bacteria (GNB) isolated from cancer patients. Materials and Methods: The present study was a hospital- based cross-sectional study carried out in Microbiology Division, Malabar Cancer Centre, Thalassery, Kerala, India, from January to March 2021. Microbiological identification of the causative agents was done by staining, culturing and biochemical methods. Screening of the isolates for ESBL was done using Double Disc Synergy Test (DDST). Antibiotic susceptibility testing was carried out using modified Kirby-Bauer disc diffusion method. The ESBL producers were genotypically confirmed through Polymerase Chain Reaction (PCR) and typed accordingly. The data were given as average with standard deviation and analysed using Microsoft Excel. Results: Out of 1,310 specimens, 366 (27.9%) were culture positive. Among the GNB, Escherichia coli (50%) followed by Klebsiella pneumoniae (46.07%), Proteus (1.96%) and Enterobacter cloacae (0.98%) were the predominant isolates. Most of these ESBL producers (Escherichia coli, Klebsiella pneumoniae) were Multidrug Resistant (MDR). However, significant isolates of Escherichia coli (98.03%), Klebsiella pneumoniae (36.1%), Proteus, (50%) and Enterobacter cloacae (100%) were sensitive to immunocompromised. Among 102 ESBL producers, prevalence of blaTEM (67.64%) was highest followed by blaCTX-M (10.78%), blaSHV (14.70%) and blaOXA (18.62%). All of the ESBL producers tested showed the presence of one of four beta- lactamase encoding genes by PCR. One of the isolate Proteus mirabilis found to be ESBL producer as confirmed by phenotypic methods but lacked ESBL genes. Conclusion: Higher prevalence of ESBL producing strains warrants stringent measures to tackle the spread of MDR strains. Carbapenems can be considered as the drug of choice against ESBL producers. Highly prevalent blaTEM gene could be considered as potential therapeutical and diagnostic target against the ESBL producing GNBs.

Speciation and Antibiotic Susceptibility Pattern of Coagulase Negative Staphylococci in a Tertiary Care Hospital of Manipur, India

Introduction: Coagulase Negative Staphylococci (CoNS) are common opportunistic pathogens. They are increasingly being recognised as nosocomial pathogens and are associated with multiple antimicrobial resistance mechanisms particularly methicillin resistance. Therefore, rapid and reliable identification upto the species level is necessary to predict the potential pathogenicity or antibiotic susceptibility of each clinical isolate. Aim: Isolation and speciation of CoNS from various clinical samples, and to determine their antibiotic susceptibility pattern. Materials and Methods: This study was a hospital-based crosssectional study carried out in the Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Imphal, Manipur, India, during the period from September 2017- August 2019. CoNS isolates were identified using conventional microbiological procedures and speciation was done following the scheme of Kloos and Schleifer. Antibiotic susceptibility was determined by using the Kirby Bauer’s disk diffusion method. Detection of methicillin resistance among CoNS was performed using cefoxitin disk (30 µg) diffusion method. Data analysis was done using descriptive statistics. Results: CoNS isolates were identified from different clinical specimens, which included 88 (65.2%) from urine, 37 (27.5%) from blood, 3 (2.2%) from pus, 2 (1.5%) from catheter tip, 2 (1.5%) from wound swab, 1 (0.7%) each from aural swab, sputum and ascitic fluid. Predominant isolates were Staphylococcus epidermidis (40.7%) followed by Staphylococcus haemolyticus (19.3%), Staphylococcus hominis (11.9%), Staphylococcus xylosus (7.4%), Staphylococcus saprophyticus (6.0%), Staphylococcus schleiferi (5.2%), Staphylococcus simulans (4.4%), Staphylococcus warneri (3.0%), Staphylococcus lugdunensis (0.7%), Staphylococcus capitis (0.7%) and Staphylococcus cohnii (0.7%). Most isolates were resistant to penicillin (84.5%) and erythromycin (59.3%), and least to tigecycline (2.2%). No resistance to vancomycin and linezolid was seen. Methicillin sensitive CoNS (MSCoNS) was detected in 79 (58.5%) isolates and methicillin resistant CoNS (MRCoNS) in 56 (41.5%) isolates. Conclusion: This study demonstrated the occurrence of various species of CoNS in our healthcare set up with varying antimicrobial susceptibility pattern. Therefore, there is a need for accurate identification to species level by simple, inexpensive methodology and their antibiogram.

Multi-Drug Resistance Patterns of Wound Causing Bacterial Infections in a Rural Hospital, Sirajganj, Bangladesh

Wound infection is considered as one of the most common nosocomial infections in the world. The aim of this study is profiling of bacterial pathogenic isolates from wound infected patients who were admitted to the hospital and commonly to measure antimicrobial susceptibility profiling. An entire of 58 samples were collected for the study. The cultural analysis was done by phenotypic examination, and we performed Gram staining and biochemical examination for identification. The pus and wound swabs were collected aseptically and gold standard microbiological cultural analysis was performed in AlHera General Hospital, Sirajganj, Bangladesh between September 2020 and August 2021. 43(74.1%) of the whole samples yielded positive cultures and only 15(25.9%) samples showed negative growth. Gram-Negative bacteria showed more prevalence than Gram-Positive bacteria which were in number 32 and 11 respectively and in at 74.4% and 25.6%. The most predominant isolate was Escherichia coli 18 (41.9%) and second most was Staphylococcus aureus 12(27.9%), and the rest of other bacterial isolates were Pseudomonas aeruginosa was 5(11.6%), Proteus mirabilis 3(7.0%), Serratia marcescens 2(4.7%), Staphylococcus Saprophyticus 2(4.7%) and Klebsiella pneumoniae 1(2.3%). The isolates were resistant to the commonly used oral antibiotics, namely Azithromycin, Amoxicilin, Ceftriaxone, Ceftazidime, Chloramphenicol, Cefixime, Amoxyclav, Colistin, Cefuroxime, Cloxacillin, Ciprofloxacin, Imipenem, Levofloxacilin, Vancomycin, Linezolid, Meropenem, Erythromycin, Gentamycin, Cephradine, Cotrimoxazole, Moxifloxacin which is very alarming. The pathogens showed remarkable sensitivity against Gentamicin and Meropenem, which at least leaves a window to get treated. This study was performed to hunt out appropriate antibiotic/s for wound infections based on pathogens isolated from wounds of hospital admitted patients in Bangladesh and their antibiotic susceptibility profile against available and frequently prescribed antibiotics.

Bacterial isolates, antibiogram and outcomes of blood culture proven sepsis in neonates at a tertiary institution in South East Nigeria: a cross-sectional study.

Background:Neonatal sepsis (NNS) in developing countries continues to be a diagnostic and management challenge due to the delays in identifying the aetiologic pathogens and antibiograms.Aim:To determine the predominant bacterial isolates, antibiotic susceptibility pattern and outcomes of blood culture proven sepsis in neonates.Methodology:A hospital-based cross-sectional study of 120 neonates admitted into the Special Care Baby Unit (SCBU) of Nnamdi Azikiwe University Teaching Hospital Nnewi with clinical features suggestive of sepsis. A semi-structured questionnaire and proforma were used to record neonatal, maternal and laboratory information. Blood specimens were collected for aerobic culture using Bactenecin (BACTEC)-Ped plus culture system. Antibiotic susceptibility testing was performed using the Kirby Bauer disc diffusion method. Data obtained were analysed using SPSS version 23.0. p value < 0.05 was considered as significant.Results:There were 68 males and 52 females giving a male-to-female ratio of 1.3:1. The median age at admission was 48 h. Staphylococcus aureus 13 (43.3%) was the most common bacteria isolated. The prevalence of blood culture proven sepsis were 25% and 6.7% of the subjects with positive blood culture died. Gram-positive bacteria isolated were sensitive to gentamicin, vancomycin (VA), linezolid and resistant to penicillin. Gram-negative bacteria isolated were sensitive to meropenem (MEM), imipenem (IPM), ciprofloxacin (CIP) and resistant to ceftazidime, ceftriaxone, ampicillin and amoxicillin-clavulanic acid.Conclusion:The most common bacteria isolated causing NNS using BACTEC automated blood culture system was Staphylococcus aureus. The empirical antibiotics considered for use at the study site are gentamycin, VA for Gram-positive organisms and CIP, IPM and MEM for Gram-negative organisms. Some of the participants with positive blood culture died. Therefore, there is a need for regular antibiogram profiles in all hospitals offering neonatal care.

Study of the current pattern of bacterial isolates with nasolacrimal passage obstruction and their antibiotic sensitivity patterns in a teaching hospital

Introduction: An acquired nasolacrimal duct obstruction can occur at any age, and is classified as either primary or secondary. The nasolacrimal obstruction occurring primarily also known as PANDO (Primary acquired nasolacrimal duct obstruction) is observed mainly in conditions occurring due to inflammation or fibrosis. Material and methods: This was a prospective observational study with a sample size of 100 patients. All the patients coming to Ophthalmology OPD with the complaints of epiphora, discharge or both along with regurgitation on pressure over lacrimal sac and mucoid or mucopurulent or clear regurgitant material on sac syringing were taken. Before the beginning of the investigative procedure, informed consent was taken. The Clinical and Laboratory Standards Institute's standardised Kirby-Bauer disc diffusion test was used to determine antibiotic susceptibility. Results: In our study, the distribution of patients according to bacterial isolates was as follows, a maximum of 62% patients were found with no growth while 18% MSSA, 10% CONS, 6% S.pneumoniae, 4% Pseudomonas were observed respectively. In our study, CONS was observed as the predominant bacterial isolate in the diabetics with a Female preponderance followed by MSSA (39%), Pseudomonas (75%) and S.pneumoniae (34%). We found Ciprofloxacin as a broad-spectrum antibiotic that works against most bacterial isolates. Conclusion: A higher female preponderance was observed in our study with the left side being affected in most of the patients. We also observed that most of the patients hailed from rural areas and belonged to lower socio-economic class. This is attributed to a lack of hygiene and awareness among low socioeconomic groups. In all the patients showing positive culture growth, Gram-positive organisms were the dominant species. We conclude, Ciprofloxacin as broad-spectrum antibiotic works against most bacterial isolates.

Pattern of Bacterial Isolates in Patients with Nasolacrimal Passage Obstruction and their Antibiotic Sensitivity Pattern in a Tertiary Care Teaching Hospital, Pune, India

Introduction: An acquired Nasolacrimal Duct Obstruction (NLDO) can occur at any age, and is classified as either primary or secondary. The nasolacrimal obstruction occurring primarily also known as Primary Acquired Nasolacrimal Duct Obstruction (PANDO) is observed mainly in conditions occurring due to inflammation or fibrosis. Aim: To study the current pattern of bacterial isolates with nasolacrimal passage obstruction and their antibiotic sensitivity patterns. Materials and Methods: This was a cross-sectional study conducted in the Department of Ophthalmology at Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India, over the period of two years from November 2019 to November 2021. A total of 100 patients were selected for the study. All the patients coming to Ophthalmology Out-patient Department (OPD) with the complaints of epiphora discharge, or both along with regurgitation on pressure over lacrimal sac and mucoid or mucopurulent or clear regurgitant material on sac syringing were taken. Before the beginning of the investigative procedure, informed consent was taken. The Clinical and Laboratory Standards Institute’s (CLSI) standardised Kirby-Bauer disc diffusion test was used to determine antibiotic susceptibility. Results: In the present study, the distribution of patients according to bacterial isolates was as follows, a maximum of 62% of patients were found with no growth while 18% methicillinsensitive Staphylococcus aureus (MSSA), 10% Coagulasenegative staphylococci (CoNS), 6% Streptococcus pneumoniae (S. pneumoniae), 4% Pseudomonas were observed respectively. In present study, CoNS was observed as the predominant bacterial isolate in the diabetics with a female preponderance followed by MSSA (39%), Pseudomonas (75%), and S. pneumoniae (33%). This study found ciprofloxacin as a broad-spectrum antibiotic that worked against most bacterial isolates. Conclusion: A higher female preponderance was observed in this study with the left side being affected in most of the patients. The pattern of antibiotic sensitivity varies from region to region and thus should be kept in mind while prescribing antimicrobial therapy to the patients.

Isolation, Identification and Antifungal Susceptibility Testing of Candida Species: A Cross-sectional Study from Manipur, India

ABSTRACT Introduction: Candidiasis is an opportunistic infection which occurs due to indiscriminate and prolonged use of broadspectrum antimicrobials, corticosteroids, immunosuppressive agents, diabetes mellitus, Human Immunodeficiency Virus (HIV), chronic renal failure, haemodialysis, renal transplantation or indwelling urinary catheter. Recently, Non-albicans Candida (NAC) species have replaced Candida albicans and emerged as an important opportunistic pathogens exhibiting decreased susceptibility to commonly used antifungal agents. Early speciation of Candida isolates along with their antifungal susceptibility testing not only will restrict the empirical use of antifungal agent but also greatly influence the treatment options for the clinicians. Aim: To speciate Candida isolates from various clinical specimens and to determine their antifungal susceptibility pattern. Materials and Methods: This study was a cross-sectional study carried out in the Mycology Section, Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Imphal, Manipur, India, from September 2016-August 2018. Candida isolates were identified using standard microbiological procedures, and speciation was done following conventional and HiCrome differential media. Antifungal susceptibility testing was determined by using Clinical and Laboratory Standards Institute (CLSI) disk diffusion method. Data analysis was done using descriptive statistics and Chi-square test. Results: A total of 100 isolates were identified from different clinical specimens, which included 43 (43%) from sputum, 34 (34%) from urine, in majority. Highest age was 92 years and lowest age was one year from whom the isolates were detected and females (57%) outnumbered males (43%) patients. Predominant Candida isolates were Candida albicans (44%), Candida tropicalis (32%). Among the azoles, the most sensitive agent was voriconazole (86%) and least was ketoconazole (56%), 81% of the total isolates were found sensitive to amphotericin B. Conclusion: The present study demonstrated that NAC spp. have surpassed Candida albicans and there is an increase in the resistance of the Candida isolates to commonly used antifungal agents. Therefore, this study highlights the need for speciation of Candida isolates upto species level and to determine the antifungal susceptibility pattern to decrease the morbidity and mortality of the patients.

Isolation, Identification and Speciation of Dermatophyte Infection in a Tertiary Care Hospital

Introduction: The common fungal infections seen in human are Dermatophytoses. They are capable to invade keratinized tissues. Mainly affect the skin, hair and nail, therefore, called as keratinophilic fungi. Dermatophytes falls under three Genus known as Trichophyton, Epidermophyton and Microsporum collectively called as dermatophytes. Unlike bacteria fungi are multicellular and are having different and specific morphology. They can be grown in the artificial media at room temperature and in human body temperature Objective: Isolation and identification of fungi will help to select the appropriate antifungal management of dermatophyte infection. Methodology: For isolation identification and speciation of dermatophytes the clinical specimens should be collected from skin, nail and hair which are obtained from patients attending the Dermatology department. Over a period of one and half year. A total no of 180 samples are collected from the patients. Samples are examined under direct microscopy in 10%, and 40% KOH. The morphology of the fungal hyphae is studied. Samples are also inoculated onto SDA and incubated at 25C and 37C for14 days. The colony characteristics and microscopic morphology in LPCB preparations are also examined. Based on the results the fungiare identified. Further speciation was carried out by using hair perforation test and Urease test. Results: All the 180 clinically suspected specimen of dermatophytes when examined results showed that most of the cases are seen between the age group of 21and 30 years. The predominant isolates belong to the genus Trichophyton (96.70%). Among the Trichophyton species mentagrophytes is the most common isolate (58.24%) T. rubrum is the next important species isolated. Conclusion: Early identification of the dermatophytes and timely given therapy will be of greater value in the prevention of fungal infection.

A Clinico Mycological Study of Tinea Pseudoimbricata.

Introduction:Tinea pseudoimbricata is a variant of dermatophytosis characterized morphologically by concentric scaly rings resembling tinea imbricata with an culture isolate other than Trichophyton concentricum. To date, no large case report series is available.Aim:To study the clinical profile and the fungus isolated in patients with tinea pseudoimbricata.Materials and Methods:In this case series, all the patients with tinea imbricata with an isolate other than Trichophyton concentricum were subjected to a detailed history and clinical examination. Scrapings of the scales were investigated with potassium hydroxide examination and culture in Sabouraud Dextrose Agar enriched with cycloheximide and chloramphenicol. The results obtained were tabulated and analyzed.Results:A total of 42 patients fulfilling the above culture criteria were included in the present study. A majority were in the age group of 21–40 years (54.70%) with a male preponderance (M:F = 2:1). All the patients had abused steroids for more than 4 weeks and had multiple site involvement. Trichophyton tonsurans (42.8%) was the predominant isolate cultured, followed by Trichophyton mentagrophytes.Conclusion:Hence, as per our study, tinea pseudoimbricata is encountered more often nowadays due to the misuse of topical steroids and to diagnose tinea pseudoimbricata culture is mandatory. The morphology of concentric rings is not restricted to Trichophyton concentricum, but can occur with other species depending on the clinical scenario.

Detection of Extended Spectrum β-Lactamases (ESBL) Producing Bacteria in Sepsis Suspected Neonates

Introduction: Neonatal sepsis is a clinical syndrome that is caused when the bloodstream of an infant is invaded by bacteria in the first month after birth. Objective: The objective of the study was to identify bacteria involved in the infection and to determine “extended-spectrum beta-lactamase” (ESBL) producing bacteria from blood samples of sepsis suspected neonates in the Neonatal Intensive Care Unit and Special Care Baby Unit. Methods: This cross-sectional study was conducted from January to July 2019 at Microbiology laboratory of Paropakar Maternity and Women’s Hospital. A total of 380 venous blood specimens were included in the study. The blood culture was performed and organisms were identified with standard microbiological methods. The Antibiotic susceptibility test was performed using the modified Kirby Bauer disk diffusion method. Screening of the organisms was done using cefotaxime and ceftazidime antibiotic disc and confirmation of ESBL was done by combined disk test. The data were considered statistically significant if the p-value was &lt; 0.05. Results: Out of a total of 380 blood specimens, the prevalence of neonatal sepsis was found to be 21.05% among which 57.5% were EOS type and 42.5% were LOS type. In EOS, E. coli (72.73%) was the predominant isolate while CoNS (100%) was the predominant isolate in LOS. Of the total 80 isolates, 65% isolates were found multidrug-resistant (MDR) whereas 58.75% of isolates were found to be ESBL producers. Conclusions: This study concludes that routine bacterial surveillance and study of their resistance patterns is an essential component of the neonatal care unit. Keywords: Extended-spectrum β-Lactamases; neonates; neonate intensive care unit; special care baby unit; sepsis.