INTRODUCTION-HIV/AIDS pandemic is responsible for the resurgence of Tuberculosis worldwide, resulting in increased morbidity and mortality. Co-infection with HIV infection leads to difficulty in both the diagnosis and treatment of Tuberculosis, increased risk of death, treatment failure and relapse. OBJECTIVE-The present study highlights the correlation of Pulmonary Tuberculosis in HIV positive cases and its association with CD 4 count. MATERIAL & METHODS-A total of 72 known case of HIV were screened for tuberculosis infection by clinical examination, radiology & ZN staining. RESULTS AND CONCLUSIONS-From our study 60 (83.33%) were diagnosed as tuberculosis and 12 (16.67%) were negative. More common HIV infection in case of male 48 (66.67%). Out of 60 tuberculosis infection 53 (88.33%) were diagnosed as Pulmonary Tuberculosis and 7 (11.67%) were diagnosed as Extrapulmonary Tuberculosis. The result of study emphasizes that co-infection of tuberculosis in HIV/AIDS patient is a concern. There is direct correlation between CD 4 counts depletion and Pulmonary Tuberculosis in HIV/AIDS patients.

BACKGROUND: Extended Spectrum β-lactamases (ESBL) are enzymes that have the ability to hydrolyze β-lactam antibiotics containing oxyimino group and are inhibited by βlactamase inhibitors. These enzymes are responsible for resistance to penicillins, monobactams, third generation and in some instances fourth generation cephalosporins. ESBLs are encoded by transferable conjugative plasmids that often code for resistance to other antibiotics as well. OBJECTIVE: This prospective study aimed to determine ESBL production in Gram negative bacteria in patients attending a tertiary care hospital in eastern Bihar. METHOD: A total of 556 samples from patients attending inpatient and outpatient departments from May 2009 to April 2010 were included in the study. Samples were processed as per standard protocol and antibiotic susceptibility testing was done by modified Kirby-Bauer method. Isolates showing resistance to any third generation cephalosporin were subjected to Double Disc Synergy Test (DDST), Phenotypic Confirmatory Disc Diffusion Test (PCDDT) and MIC reduction test for ESBL production. RESULTS: 42.62% of Gram negative bacilli were ESBL producers. 56.3% of Klebsiella pneumoniae strains were found to be ESBL producers whereas only 40.5% of Escherichia coli produced ESBL. PCDDT and MIC reduction test showed 100% correlation whereas the DDST failed to detect 13.5% of ESBL producers. All ESBL producers were sensitive to Imipenem and Cefoperazone/ Sulbactam. CONCLUSION: The present study gives us an indication regarding the occurrence of ESBL producing Gram negative bacilli in Eastern Bihar. The number of ESBL producers in this region is alarmingly large. It is therefore recommended that PCDDT be incorporated in all laboratories as a part of routine antibiotic susceptibility testing procedures as it is simple, reliable and reproducible test for detection of ESBLs.

Diarrhoea is defined as passage of loose, liquid or watery stools. In the developing countries, diarrhoea remains a wet season disease with bacteria playing a greater role. The agents responsible for infantile diarrhoea may be bacteria, viruses, parasites, malnutrition and drugs. Infectious agents that cause diarrhoeal disease are usually spread by the fecal-oral route. Escherichia coli (E. coli) is a gram-negative bacillus that may be found in the normal intestinal flora of humans and animals, but can also be an important cause of enteric illness. Our present study is an attempt to fulfil this vacuum and investigate the most common pathogens causing these diseases amongst patients in and around a tertiary care hospital of eastern Bihar, with special reference to the serotypes of Escherichia coli. MATERIAL AND METHODS: Samples were collected from both male and female patients below five years of age, admitted to the Pediatrics Department, with complains of diarrhoea and gastroenteritis. Samples were processed, identified and antibiotic sensitivity was done as per standard protocol. Serotyping of E. coli isolates was carried out using antisera as per manufacturer's instructions. RESULTS: Different diarrhoeagenic strains of E. coli showed that the maximum numbers of strains were EPEC, followed by DAEC. EAEC and ETEC accounted for only a small percentage of strains. Upon Serotyping the different E. coli isolates from patients with diarrhoea, the results showed that the Serotype O26, O111 and O55 were the predominant serotypes of EPEC. Among the ETEC strains only 2 serotypes were seen viz. O6 and O15. Serotype O44 and O125 were the only two serotypes of EAEC seen. Among the DAEC, the only serotype was O1. The antibiotic susceptibility pattern of various isolates shows maximum resistance against ampicillin followed by cefixime. Strains were significantly sensitive to amikacin, gentamicin and ofloxacin. CONCLUSION: Our result shows high rate of diarrhoeagenic E. coli among Indian children presenting with diarrhoea particularly in Katihar / Kosi region of Bihar. The finding of diverse E. coli subtypes even amongst the small number of E. coli isolates highlights the importance of pathogenic E. coli in cases of diarrhoea and gastroenteritis and stresses upon the need for enhanced surveillance of children with diarrhoea in these parts of the globe.

BACKGROUNDInjuries secondary to severe burns rank among the most serious forms of trauma resulting in anatomic, physiologic, endocrinologic and immunologic stress, especially when burns involve more than 20% of Total Body Surface Area (TBSA). In patients surviving the initial burn and resuscitative phase, infections are a leading cause of mortality. The burnt surface is sterile immediately following thermal injury but after 48 hours the wound is colonised with skin pathogens that typically reside in sweat glands and hair follicles before the burn. After 5 to 7 days, wounds become colonised with yeast and/or Gram-positive and Gram-negative organisms from the host's intestinal and upper respiratory tracts, or from the hospital environment and health care workers' hands.

BACKGROUNDPseudomonas aeruginosa is a leading cause of nosocomial infection due to its numerous intrinsic and acquired mechanisms of drug resistance. Although antibiotic resistance in P. aeruginosa is caused by multiple mechanisms, one major factor leading to resistance is the production of carbapenemases. Metallo-β-lactamases (MBLs) are carbapenemases which require zinc at the active site and are predominantly produced by P. aeruginosa. The selection criteria for confirmation of MBL producers are reduced susceptibility or resistance to carbapenems and/or ceftazidime.The aim of the study was to determine the efficacy of three antibiotics viz., meropenem, imipenem and ceftazidime as a screening and confirmatory agent for detection of MBL and to assess the diagnostic potential of DDST, DPT and MIC reduction test for detection of MBL.