Introduction: Carbapenem resistance in Gram-negative bacilli (GNB) is a major concern in the management of resistant infections. The mechanism of carbapenem resistance is most commonly mediated by carbapenemases. The five most common genes (NDM, KPC, VIM, OXA, and IMP) are responsible for carbapenemase production. Knowledge of these genes is important for the management of the disease. Objective: To estimate the prevalence of different genes responsible for carbapenemase production in GNB at a tertiary healthcare centre in South India. Method: In this retrospective study, samples were collected over 16 months. Carbapenem-resistant GNB underwent to Xpert Carba-R assay (Cepheid, Sunnyvale, California, USA) for the detection of five important genes responsible for carbapenemase production: NDM, KPC, VIM, OXA, and IMP. Results: Out of 184 carbapenem-resistant GNB, 20 samples were not included in this study. The rest of the 164 samples grew Klebsiella pneumoniae (152), Escherichia coli (10), and Enterobacter (2). OXA-48 and NDM were the most common genes responsible, with 137 (84.5%) and 95 (58.6%), respectively. Among them, 70 (43.2%) showed the presence of both genes, and 1 (0.6%) showed the presence of OXA-48, NDM, and VIM. Individually, 66 (40.7%) of OXA-48, 24 (14.8%) of NDM, and one (0.6%) of VIM. In this study, the authors did not find the presence of IMP or KPC genes. Conclusion: As a result of limited options and the higher cost of antibiotics for carbapenem-resistant infections, knowledge of these genes helps in the selection and rational use of antibiotics reduces the cost of management and will prevent mortality and morbidity from these infections.

Background: Low Birth Weight newborns are either Preterm or IUGR. These both have different morbidities and outcomes. KMC is an effective intervention for LBW infants. Here authors study the effectiveness of KMC in preterm babies and full term IUGR babies.Methods: Prospective, Observational, comparative study in which 50 Preterm AGA and 50 Term IUGR included which are hemodynamically stable. effective KMC given and their daily weight gain were observed.Results: Term IUGR having average birthweight is 2083.7±177.9 gm and discharge weight 2179.4±183.8 and preterm AGA are having average birthweight 1972.9±198.9gm and weight on discharge 1962.2±201.0. IUGR term newborns had mean weight loss for 0.90±1.05 days with mean weight loss of 17.94±28.8 grams with average weight loss of 0.9% followed by mean weight gain of 26.6±14.2 grams per day for mean 4.36±0.74 days. Preterm AGA shows weight loss for 3.54±1.5 days with mean weight loss of 98.06±80.83 grams and average 5.4% followed by mean weight gain of 20.4±8.9 grams 4.22±0.97 per day for mean 4.36±0.74 days. With average hospital stay of 5.26±1.2 and 7.76±1.51 days respectively for Term IUGR and Preterm AGA.Conclusions: KMC helps in decreasing the morbidities, achieving physiological weight gain and early discharge in both IUGR term and preterm AGA new-borns but maintaining their physiological pattern of weight gain.