High prevalence of MRSA is a cause of concern and strategies to interrupt transmission should be implemented.

This study aims to determine drug sensitivity, metallo-beta-lactamase (MBL) production and elaboration of bla(OXA)-type carbapenemases in Acinetobacter spp. in a temperate climate area in north India with a heavy influx of tourists. Antimicrobial sensitivity of 165 isolates was performed. Imipenem-resistant isolates were subjected to combined disk (CDT) and double-disk diffusion tests (DDT) for MBL detection. Minimum inhibitory concentration (MIC) and MBL production were tested by Etest. A multiplex polymerase chain reaction (PCR) was performed for the detection of genes encoding bla(OXA)-23 like, bla(OXA-24) like, bla(OXA-51) like and bla(OXA-58) like genes. Ninety-nine (60%) isolates were imipenem-resistant (MICs 2-96 microg/mL). Fifty (50.5%) of the 99 carbapenem-resistant isolates were MBL producers by CDT and 26 (26.3%) by DDT. The majority (77%) of the isolates elaborated bla(OXA-23) and bla(OXA-51) like genes. Forty seven of the 50 MBL-positive isolates harboured bla(OXA-23) like and bla(OXA-51) like genes. MBL-producing Acinetobacter has emerged as a major pathogen in Kashmir with elaboration of bla(OXA-23) and bla(OXA-51) related carbapenemases. This poses a significant challenge for healthcare professionals and policy planners, and needs to be addressed immediately. Primary care physicians treating visitors to Kashmir need to be aware of the situation.

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Introduction: Female genitourinary tuberculosis (FGTB) is an important cause of infertility in women of reproductive age group. The disease remains undetected due to its asymptomatic nature and lack of sensitive tests. This study was conducted with the aim of detecting the prevalence of genital tuberculosis in infertile women. Material and methods: Endometrial curetting of 193 infertile women suspected of genital tuberculosis were taken laparoscopically and sent for histopathological examination, ZN staining, culture on LJ media and GeneXpert testing. Results: Out of 193 women, 13 were positive for Mycobacterium tuberculosis making the overall prevalence of FGTB in infertile women to the extent of 6.73%. Of these 11 presented with primary infertility while 2 patients presented with secondary infertility. The histopathological examination of all the samples was non-specific. No case of positive acid fast bacilli on ZN staining was observed. Comparison of culture and GeneXpert revealed that Xpert assay was more sensitive in detecting the positive cases. Conclusion: Our study concluded that FGTB is common in our population and women presenting with infertility should be evaluated for genital tuberculosis. A high degree of suspicion and combination of histopathological and microbiological tests are important methods for the detection of genital tuberculosis

Background: Tuberculosis is a global health problem associated with high morbidity and mortality. Rapid diagnosis of tuberculosis is essential for early disease management. Conventional methods like microscopy and culture are associated with low sensitivity and longer time to positivity respectively. The GeneXpert is an integrated device for the rapid detection of Mycobacterium tuberculosis and its sensitivity to rifampicin. We evaluated the performance of gene expert MTB/ RIF assay for the diagnosis of pulmonary and extrapulmonary tuberculosis.Methods: A prospective cross sectional study was carried out in the Department of Microbiology. Samples were subjected to smear microscopy by ZN staining, culture on solid (LJ) and liquid media (BacT Alert) and GeneXpert assay.Results: 122 pulmonary samples and 153 extrapulmonary samples collected from 275 patients were included in the study. Out of these, 48 samples were positive by both culture and Xpert assay and 2 samples were culture positive only. Out of 225 culture negative samples, 3 were positive by GeneXpert. The sensitivity for GeneXpert was much higher compared to smear micrscopy (96 Vs 46% respectively). The Xpert assay also detected 3 rifampcin resistant cases.Conclusions: The test appeared to be as sensitive as culture for the detection of tuberculosis in smear positive, smear negative and extrapulmonary tuberculosis. We recommend the use of GeneXpert assay for the early detection of tuberculosis. We conclude that the test is simple and routine staff can perform the test with minimal training.