Introduction: Infections associated with catheter in the upper urinary tract (CUUT), which include the double-J stent and the percutaneous nephrostomy (PCN) tube, get particularly infected in patients with specific risk factors for developing an infection. Methods: A retrospective observational study was carried out by compiling data from the hospital information system of a tertiary care center from 2019 to 2021 to evaluate infections in patients with catheter in the upper urinary tract. Result: A total of 200 pus samples of double-J stent (96 pus samples) and PCN tube (104 pus samples) were included in our study. Among patients with nephrostomy tube, the most frequently isolated microorganisms were Escherichia coli, followed by Pseudomonas spp. In those with a double-J stent, Pseudomonas aeruginosa, followed by E. coli were the most commonly isolated microorganisms. We found 55.72% of cases of Enterobacteriaceae-producing carbapenemases in patients with a percutaneous catheter. 66.07% of Enterobacteriaceae in patients with double-J and nephrostomy stents are extended-spectrum beta-lactamase-producing bacteria. The percentage of cultures with multiple-drug resistance (MDR) microorganisms was 38.54% in patients with double-J stents and 37.75% in nephrostomy tubes. The presence of prior urinary tract infection (P = 0.010), presence of urinary catheter before admission (P = 0.005), increased time with single urinary catheter in-situ (P < 0.001), and increased length of hospital stay (P = 0.036) were risk factors for isolation of MDR microorganisms. Conclusion: Pseudomonas spp. and Pseudomonas aeruginosa are commonly infecting both the CUUT. E. coli infections are more commonly infecting the nephrostomy tubes. MDR microorganisms are frequent, mainly in patients with prior urinary tract infection, presence of urinary catheter before admission, and prolonged use of a single catheter.

A BSTRACT Context: Knowledge of epidemiology of bacterial isolates and their anti-biograms in hospital settings is necessary for prompt empirical anti-microbial therapy of neonatal sepsis. Aims: To study risk factors, bacteriological profiles, and anti-biograms of blood culture isolates of both early and late onset neonatal sepsis. Settings and Design: It is a prospective observational study conducted from January 2020 till July 2021 at our tertiary care center. Material and Methods: Neonates (0–28 days) admitted to this neonatal intensive care unit clinically suspected with sepsis were subjected to blood cultures, and the isolates were identified both biochemically and by the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry system. Antibiotic susceptibility testing (AST) was performed as per CLSI guidelines. Statistical Analysis: Chi-square test was used. Results: Out of 280 suspected cases of neonatal sepsis, 43 (15.3%) cases showed positive blood culture. Of these, the majority (30, 69.8%) had late-onset neonatal sepsis. Major pre-disposing risk factors were pre-term birth and a low birth weight (26, 60.5%). Gram-negative bacteria and Gram-positive bacteria were isolated in 25 (58.1%) and 18 (41.9%) blood cultures, respectively. Klebsiella pneumoniae (37.5%) was the most predominant pathogen in both early-onset (23.1%) and late-onset (46.7%) sepsis. Coagulase negative Staphylococcus (34.8%) was the second most common organism and was more common in late onset (23.2%) neonatal sepsis. A high level of antibiotic resistance was noted in Klebsiella pneumoniae isolates, even to amikacin (76.5%) and carbapenems (66.7%). Conclusion: Increased resistance in bacterial isolates of neonatal sepsis emphasizes the need of AST of bacterial isolates for proper antibiotic administration.

Achromobacter xylosoxidans subspecies denitrificans flourishes in presence of oxygen, commonly isolated from aquatic milieu. It is rarely implicated as the causative agent of endocarditis. It is not known to cause virulent infections in patients but causes severe infections in immunosuppressed patients with underlying co-morbidities. Present report is first case of Achromobacter xylosoxidans prosthetic valve endocarditis from India. This case report accounts for a 47-year-old man, suffering from Rheumatic Heart Disease (RHD), who presented to the cardiology emergency with chief complaints of remitting type high-grade fever for years years followed by persistent fever for 10 days. On echocardiography and positively flagged BACTEC blood culture reports was diagnosed as a case of Achromobacter xylosoxidans subspecies denitrificans bacteraemia and prosthetic aortic valve endocarditis. Antibiotics were started according to the susceptibility testing but the patient could not complete the course of treatment as he developed dyspnoea and cardiac arrest following which he could not be resuscitated.

Introduction: Achromobacter is a Gram-negative, motile, obligate aerobic, and non-fermentative bacterium. It is an emerging pathogen in the hospital environment as it is frequently found in various solutions. Hypothesis/Gap Statement: Information about the incidence and risk factors of Achromobacter bacteremia from India is limited. Aim: We conducted this study to identify the risk factors and underlying conditions predisposing to bacteremia by Achromobacter spp and analyze the antibiotic resistance pattern of the isolates. Methodology: We performed a retrospective observational study where automated blood cultures positive for Achromobacter spp were assessed for clinical characteristics and antibiotic susceptibility patterns from January 2022 to December 2022 in the microbiology laboratory of a tertiary care center in Northern India. Results: A total of fourteen cases of Achromobacter spp were identified from bloodstream infections in one year. The mean age of the patients was 37.59 ± 23.17 years with a male predominance (8/14, 57.1%). All patients were managed on intravenous antibiotics and intravenous access as peripheral line catheters and only 5 (5/14, 35.7%) patients were managed on central line catheters. The most common antibiotic found to be susceptible against Achromobacter spp was Ticarcillin- clavulanic acid (14/14, 100.0%) followed by Fluoroquinolones (12/14, 85.72%) and Trimethoprim- sulphamethoxazole (12/14, 85.72%). The all-cause 40-day mortality was observed in 35.7% (5/14, 35.7%) with two death that was directly attributable to sepsis. Conclusion: This study provides insight into the incidence of Achromobacter bacteremia at our center and the necessary antibiotic therapy to combat it.

Background: Patients suffering from trauma, burns or those who have undergone surgical interventions are susceptible to pyogenic infections caused by commensal as well as exogenously acquired pathogens. This study helps us recognize and characterize aerobic bacteria isolated from pyogenic samples and establish antibiotic resistance for clinicians to devise an empirical treatment for patients suffering from similar disease. Methods: This observational study was carried out from November 2019 to May 2020 in the Department of Microbiology at a teaching hospital in northern India and included all patients who presented with suppurative infections during the study period. Results: Total 201 culture positive samples were included in our study of which 80 (40%) samples were of sterile body fluids, 51 (25%) samples were of pus aspirates and the other samples included wound pus and surgical site infection samples. Escherichia coli was the most common pathogen (30.34%) followed by Klebsiella pneumoniae (17.91%) and Pseudomonas spp (13.43%).Sixty eight (33.83%) isolates were multidrug resistant. Enterobacter spp was completely resistant to ciprofloxacin, ceftazidime and ceftriaxone, and 25% sensitive to Cefoperazone-Sulbactam, thus showing the presence of extended spectrum beta lactamase (ESBL) character. We studied the association of multidrug resistance to certain risk factors like previous antibiotic therapy, days of wound before admission, increased length of hospital stay, patient comorbidities like diabetes mellitus, heart disease, chronic liver disease and immunosupression. Conclusions: This study reveals Gram negative bacilli to be more commonly causing pyogenic infections in our patients. Local antibiotic susceptibility profile of these pathogens is essential for empirical treatment.