Introduction: Carbapenems are considered to be the last choice for drug resistant Gram-negative bacteria but emergence of carbapenem resistant Gram-negative bacteria worldwide due to the production of carbapenemase has jeopardize their use. Aims and objectives:To detect the prevalence of carbapenem resistance in Gram-negative bacteria and carbapenemase production by Modified Hodge Test. Materials and Methods:A total of 160 isolates of Gram-negative bacteria from November 2012 to October 2014, from different clinical samples were included in the study. Those isolates with intermediate or resistant zone to meropenem and doripenem by disc diffusion methods according to CLSI guidelines were confirmed by E-test and were again tested for carbapenemase production by Modified Hodge Test (MHT). Results: Out of 160 isolates, 48 (30%) showed resistance to carbapenem by disc diffusion and E-test.Carbapenem resistance was higher in female patients 41.6% than in male patients 15.5% and among ICU patients 57.1%, ward patients 33.3% and among OPD patients 13.8%. Maximum number of carbapenem resistant isolate was obtained from urine sample n= 20, followed by pus n=13 and wound swab n=7. MHT for carbapenemase production was positive in 29 (60.4%) of the isolates. Carbapenemase production by MHT was highest with Acinetobacter spp. with n=5 (83.3%), followed by Pseudomonas spp. n= 6 (75%) and E.coli spp. n=16 (65.5%) and nil among Citrobacter spp. Conclusions:Carbapenem resistance due to production of carbapenemase is prevalent in our hospital. MHT is a simple test in the routine lab for detection of carbapenemases.

A total of 1903 commercial sex workers (CSWs) attending the Voluntary and Confidential Counseling and Testing Centre at the Department of Microbiology, Regional Institute of Medical Sciences, Manipur, were screened for HIV infection over a period of five years from March 1998 to February 2003. All cases were in the age group 13-55 years. Most cases were in the age group 20-30 years (50.86%). Out of 1903 CSWs, 304 were found to be HIV-seropositive, confirmed by three tests (ELISA/RAPID/SIMPLE) of different biological antigen principles according to India's National AIDS Control Organisation guidelines. The annual rising trend in incidence of HIV seropositivity among CSWs from March 1998 (10.93%) to February 2003 (29.68%) was observed in the test site attenders, in contrast to the declining trend among injecting drug users in the state from March 1998 (76%) to February 2003 (59.82%). In all, 622 sexually transmitted infection (STI) cases were diagnosed, of which 242 (38.90%) had syphilis, which was the commonest STI, and 172 (27.65%) had ulcerative lesions. Increasing HIV seropositivity among CSWs observed in this study reflects the changing pattern of HIV transmission in Manipur.

INTRODUCTIONPseudomonas aeruginosa is an aerobic, motile, nutritionally versatile, gram negative bacteria. It is ubiquitous, human opportunistic pathogen and has implications on morbidity, mortality and healthcare costs both in hospitals and in the community.1 Infections caused by P. aeruginosa are frequently life-threatening and difficult to treat causing increased stay in hospital and even increased morbidity and mortality as it exhibits intrinsically high resistance to many antimicrobials and the development of multi-drug resistance in health care settings.2,3 Biofilms are defined as microbially derived sessile communities characterized by the cells that are irreversibly attached to a substratum or to each other. They are embedded in a matrix of extracellular polymeric substances (EPS) they have produced, and exhibit an altered phenotype with respect to growth rate and gene transcription.4 Within a biofilm, bacteria communicate with each other by production of chemotactic particles or ABSTRACT Background: Pseudomonas aeruginosa is an ubiquitous pathogen capable of surviving in a variety of environmental conditions. It is increasingly gaining importance as a multidrug resistant nosocomial pathogen. Biofilm acts as a barrier, reducing the penetration of these drugs and consequently, preventing them from exercising their actions. The aim of this study is to isolate and identify Pseudomonas aeruginosa from various clinical specimen and to find out their production of biofilms and their correlation with antibiotic susceptibility pattern. Methods: All Pseudomonas aeruginosa over a period of 1 year were isolated and identified from clinical specimens and antibiotic susceptibility test was done following standard operative procedures. Biofilm detection was done by Congo Red Agar method (CRA). Results: 134 isolates of Pseudomonas aeruginosa was isolated. Maximum isolates were isolated from sputum samples 55 (41%) and most were from wards 68 (51%) giving a probability of increased healthcare associated infections. Biofilm production by the isolates was seen in 39 (29%). All the biofilm producing isolates shows more resistant pattern in comparison to non-biofilm producers. 69% of Imipenem and 82% of Meropenem resistant isolates produce biofilm. All the P. aeruginosa including MDR and biofilm forming strains were sensitive to Colistin. Conclusions: Resistance to antimicrobial agents is the most important feature of biofilm infections. Ability of P. aeruginosa to form biofilms renders antibiotic treatments inefficient and therefore promotes chronic infectious diseases. As a result, infections caused by bacterial biofilms are persistent and very difficult to eradicate.

Background: Acinetobacter is an important opportunistic pathogen and is a common cause of hospital acquired infections. Acinetobacter infections are often extremely difficult to treat because of their widespread resistance to the major groups of antibiotics. The study was conducted to determine prevalence and antibiotic susceptibility pattern of Acinetobacter species isolated from various clinical samples.Methods: Clinical specimens over a period of 2yrs from May 2015 to April 2017 were collected from the patients attending the hospital. Acinetobacter species isolates were identified, and antibiotic susceptibility test was done following standard operative procedures.Results: From 9979 clinical specimens, 3715 were positive for significant bacterial growth of which 111 (2.9%) were culture positive for Acinetobacter spp. Among 111 isolates 109 (98.2%) isolates were Acinetobacter baumanni and 2 (1.8%) were Acinetobacter lwoffii. Maximum isolates were isolated from urine samples 36 (32.4%) and majority of the isolates were from wards (56.7%) giving a probability of increased hospital acquired infections. Maximum resistance was shown by cefipime (80.1%). Imipenem and Meropenem shows resistance of 25.3% and 29.7% respectively. ICU isolates showed extensive resistance in comparison to wards and OPD.Conclusions: Increasing trend of resistance pattern to a large range of antibiotics is a matter of concern. To avoid resistance, antibiotics should be used judiciously, and empirical therapy should be determined for each hospital according to the resistance rates of the hospital. Infection with MDR Acinetobacter species is independently associated with high mortality, emphasizing the need for aggressive infection control strategies.

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