BackgroundStaphylococcus aureus is a frequent cause of infections in both the community and hospital. Methicillin-resistant Staphylococcus aureus continues to be an important nosocomial pathogen and infections are often difficult to manage due to its resistance to multiple antibiotics. Healthcare workers are important source of nosocomial transmission of MRSA. This study aimed to determine the nasal carriage rate of S. aureus and MRSA among healthcare workers at Universal College of Medical Sciences and Teaching Hospital, Nepal and to determine antibiotic susceptibility pattern of the isolates.MethodsA cross-sectional study involving 204 healthcare workers was conducted. Nasal swabs were collected and cultured on Mannitol salt agar. Mannitol fermenting colonies which were gram positive cocci, catalase positive and coagulase positive were identified as S. aureus. Antibiotic susceptibility test was performed by modified Kirby-Bauer disc diffusion method. Methicillin resistance was detected using cefoxitin disc diffusion method.ResultsOf 204 healthcare workers, 32 (15.7 %) were nasal carriers of S. aureus and among them 7 (21.9 %) were carrier of MRSA. Overall nasal carriage rate of MRSA was 3.4 % (7/204). Highest MRSA nasal carriage rate of 7.8 % (4/51) was found among nurses. Healthcare workers of both surgical wards and operating room accounted for 28.6 % (2/7) of MRSA carriers each. Among MRSA isolates inducible clindamycin resistance was observed in 66.7 % (2/3) of erythromycin resistant isolates.ConclusionsHigh nasal carriage of S. aureus and MRSA among healthcare workers (especially in surgery ward and operating room) necessitates improved infection control measures to be employed to control MRSA transmission in our setting.

Objective: This study aimed to determine prevalence of inducible and constitutive clindamycin resistance among clinical S. aureus isolates and also study their association with methicillin resistance. Methods: A cross-sectional study including 140 non-duplicate isolates of S. aureus was done. Isolates were identified by standard microbiological methods and methicillin resistance was detected by cefoxitin disc diffusion method. Inducible clindamycin resistance was detected by D-test. Results: Prevalence of inducible and constitutive clindamycin resistance was 12.1% and 7.9% respectively. Constitutive and inducible resistance was associated with MRSA. An unusual phenotype, erythromycin sensitive and clindamycin resistance, was detected in 2 MRSA isolates. Conclusions: Inducible and constitutive clindamycin resistance is comparatively low in our setting. Constitutive and inducible resistance was higher among MRSA than MSSA. However the trends in resistance vary in different places. D-test reporting should be done routinely which will allow clinicians to opt for clindamycin judiciously and avoid potential treatment failure.

This prospective study was conducted on burn patients visiting Victoria Hospital, Kalasipalayan, Bangalore, India from Nov 15, 2010 to June 15, 2011. A total of 100 samples were collected from the burn patients. Pus sample were collected from wound using a sterile cotton swab and transported to the laboratory using Stuart's medium without delay. Speciemen were inoculated on MacConkey agar, Blood agar and Nutrient agar plates and the plates were incubated at 37°C over night. Initial diagnosis of isolates was made on the basis of Gram's staining of pus and culture, colonial morphology on different media, haemolysis on Blood agar, pigment production on nutrient agar and smell in cultures. P. aeruginosa isolates were confirmed by biochemical tests including Oxidase test, Citrate utilization, Aesculin hydrolysis, Gelatin hydrolysis, Nitrate reduction and growth at 42°C. Sugar fermentation tests including Glucose, Sucrose, and Maltose were also performed. The antibiotic susceptibility test of P. aeruginosa isolates were performed by modified Kirby Bauer's Disc Diffusion method using 12 different antibiotics (Amikacin(30mcg), Ciprofloxacin(5mcg), Gentamicin(10mcg), Cefotaxime(30mcg), Imipenem(10 Abstract Background: Pseudomonas aeruginosa is an opportunistic pathogen that develops life-threatening infections in patients with immunological system defects like burn patients. P. aeruginosa is naturally resistant as well as able to get acquired resistance to effective antibiotics which lead to problematic conditions. This study was designed to isolate P. aeruginosa from burn patients and to evaluate drug susceptibility for determination of multidrugresistant isolates of P. aeruginosa. Materials and Methods: A prospective study was carried out on the patients visiting Victoria Hospital, Kalasipalayan, Bangalore, India from Nov 15, 2010 to June 15, 2011. The pus sample was collected using sterile cotton swab from 100 patients with burn wound infections. P. aeruginosa was identified by standard bacteriological methods. The drug susceptibility pattern using 12 different antimicrobial agents (Amikacin, Ciprofloxacin, Gentamicin, Cefotaxime, Imipenem, Meropenem, Cefoperozone, Tobramycin, Piperacillin/Tazobactum, Cefepime, Ceftazidime, and Norfloxacin) was performed for all the isolates using Kirby Bauer's Disc Diffusion Method. Results: P. aeruginosa were isolated from 17 clinical samples and all of these isolates were Multidrug Resistance P. aeruginosa (MDRPa). Resistance rates to various antibiotics were as follows: Amikacin (47.1%) Ciprofloxacin (35.5%) Gentamicin (47.1%) Cefotaxime (76.5%) Imipenem (88.2%) Meropenem (94.1%) Cefoperozone (94.1%) Tobramycin (100%) Piperacillin/Tazobactum (82.4%) Cefepime (64.7%) Ceftazidime (70.6%) Norfloxacin (70.6%). Conclusion: Optimization of using antimicrobial agents and control of infection is recommended to prevent the increasing population of MDRPa in the new burn centre setting in this study.

INTRODUCTION: The most common method for detection of drug-resistant-Tuberculosis (DR-TB) in resource-limited settings (RLSs) is indirect susceptibility testing on Lowenstein-Jensen (LJ) medium with results available only after 2-3 months. Rapid detection of drug resistance by direct Nitatre Reductase Assay (NRA) expedites Tuberculosis patient management. The objective of the study is to access the feasibility and performance of Direct NRA for detection of DR-TB in National Tuberculosis Center under the National Tuberculosis Control Programme (NTP).MATERIALS AND METHODS: Out of 416 previously treated and new pulmonary TB suspect cases; a total of 117 (28.1%) smear-positive sputa with a positivity score of 1+ or more were used in the study. The NRA results were compared with the gold standard LJ proportion method for 110 (94%) specimens while 7 were either contaminated or culture negative.RESULTS: In comparison with LJ proportion method, the respective sensitivities, specificities, NPV, PPV and kappa agreement were 97.2% (95% CI, 86-100), 95.9%(95% CI, 89-99), 92.1% (95% CI, 78-99) 98.6% (95% CI, 92-100), and 0.92 for INH, 100% (95%CI, 90-100), 98.7% (95% CI, 93-100), 97.1% (95% CI, 85-100), 100% (95% CI, 95-100) and 0.98 for RFM, 97.1% (95% CI, 85-100) ,96.1% (95%, 89-99), 91.7% (95% CI, 78-98), 98.7% ((95% CI, 93-100) and 0.92 for SM and 100% (95% CI, 88-100), 97.7% (95% CI, 91-100), 93.3% (95% CI, 78-99), 100% (95% CI, 95-100)and 0.93 for EMB.CONCLUSIONS: The results obtained by direct NRA demonstrated excellent concordance for all drugs. Direct NRA is an assay which detects DR-TB directly from sputum rapidly and has the potential to become an alternative to existing methods particularly in resource-poor settings