No abstract

Various carbapenems have been reported in Pseudomonas aeruginosa such as VIM, NDM & OXA-48, etc. In addition, carbapenemase producers are usually associated with many other non-β-lactam resistance determinants which give rise to multidrug and pan drug resistant isolates. Detection of these enzymes in infected patients and in carriers are the two main approaches for prevention of their spread. Potential carbapenemase producers are currently screened first by susceptibility testing, using breakpoint values for carbapenems. However, many carbapenemase producers do not confer obvious resistance levels to carbapenems. So there is need for Laboratories to search for carbapenemase producers. In such instance, phenotypic based test such as Modified Hodge Test (MHT) is very much useful in confirming in vitro production of carbapenemase enzymes. But this test does not differentiate serine carbapenemase enzyme (i.e. Ambler class A & C) from metallocarbapenemase (i.e. Ambler class B). To differentiate these two enzymes, MHT positive isolates can be subjected to Disc Synergy test. These two tests are highly sensitive and specific and adaptable to any laboratory in the world. Out of 100 ceftazidime resistant Pseudomonas aeruginosa, 75(75%) were sensitive, 7(7%) were intermediate sensitive and 18(18%) were resistant to imipenem. When the 18 imipenem resistant strains were subjected to Modified Hodge test, 15 gave positive results. When the 15 MHT positive strains subjected to disc synergy test, 8 were positive and 7 were negative showing that 8 were producing metallocarbapenemases and 7 were producing serine carbapenemases. Out of 7 intermediately imipenem sensitive isolates, 2 were producing metallocarbapenemase and 3 were producing serine carbapenemase. Hence, total number of imipenem resistant Pseudomonas aeruginosa isolates were 23.

BACKGROUNDThe biggest concern over UTIs in children is that they can cause permanent kidney damage and scarring. Repeated scarring can lead to high blood pressure and reduced kidney function including kidney failure. Infants and young children seem to be at higher risk for this complication.

BACKGROUND Staphylococcus aureus has long been recognised as an important pathogen in human disease. Staphylococci infection occurs regularly in hospitalised patients and has serious consequences despite antibiotic therapy. Shortly after introduction of methicillin after clinical use Methicillin-Resistant Staphylococcus Aureus (MRSA) were identified in many countries and become one of the most common causes of nosocomial infections. The aim of the study is to know the methicillin sensitivity of both coagulase-negative and coagulase-positive staphylococci isolated from various samples. MATERIALS AND METHODS 100 strains of staphylococci both coagulase positive and coagulase negative were isolated in the Department of Microbiology from various clinical samples. They were confirmed by morphology, staining methods and by using standard bacteriological procedures and biochemical reactions. Antibiotic susceptibility testing was performed by Kirby Bauer disc diffusion test. RESULTS Predominant species from pus were S. epidermidis (42.42%) and from sputum S. haemolyticus (31.81%) from blood S. haemolyticus (53.33%). 53% of strains produced beta-lactamase. Majority 47.22% by S. epidermidis from pus followed by S. haemolyticus 23.33% from pus. Beta-lactamase production was least from throat swab (5.55%). Out of 32 coagulase-positive staphylococci tested to methicillin 15 (46.87%) were found to be sensitive, 17 (53.13%) were found to be resistant. Out of 68 coagulase-negative staphylococci tested, 13 (19.11%) were found to sensitive and 55 (80.88%) were found to be resistant. 72% of strains were sensitive to novobiocin and 28% resistant to novobiocin. 43% showed drug resistance to 2 drugs. 14% to 3 drugs and 5 drugs. 6% of staphylococci sensitive to all the 10 drugs. CONCLUSION MRSA is a type of bacteria that is resistant to a number of widely used antibiotics. This means MRSA infections can be more difficult to treat than other bacterial infections. In recent years, rates of MRSA have fallen because of increased awareness of the infection by both medical staff and the public. However, MRSA still places a considerable strain on healthcare services. Some people who need to be admitted to hospital will have MRSA screening beforehand, but there are also some things you can do yourself to reduce your risk of becoming infected. These include:  Washing your hands frequently-especially after using the toilet and before and after eating.  Following any advice you are given about wound care and devices that could lead to infection (such as urinary catheters).  Reporting any unclean toilet or bathroom facilities to staff-don't be afraid to talk to staff if you're concerned about hygiene. If you're visiting someone in hospital, you can reduce the chance of spreading MRSA by cleaning your hands before and after entering the ward. You should also use hand wipes or hand gel before touching the person you're visiting.

Introduction: The irrational and inappropriate use of beta lactam antimicrobial drugs has led to the advent of Extended Spectrum Beta-Lactamase (ESBL) resistant strains. ESBL producing Enterobacteriaceae strains are frequent causative agents both in community and in acquired nosocomial infections and Urinary Tract Infections (UTI). The phenotypic confirmatory tests rarely identify all ESBLs. Chrom ID (Chromogenic identification Media) ESBL – Bx (bioMerieux) is a completely new and innovative chromogenic medium designed specifically for the screening of ESBL producing Enterobacteria directly from urine samples. It is a ready to use selective media which is sensitive and specific for rapid and presumptive identification of ESBL producing Enterobacteriaceae. Aim: Early detection of ESBL producing Enterobacteriaceae directly from urine samples on chromogenic medium (Chrom ID- ESBL- Bx) and confirmation of ESBL producing Enterobacteria using Disc Potentiation Test (DPT). Materials and Methods: The present cross-sectional study was conducted in the Department of Microbiology, Rangaraya Medical College, Kakinada, Andhra Pradesh, India from November 2019 to March 2020 (five months duration). The study was done on 70 urine samples from patients with UTI. All samples were subjected to wet mount, inoculated directly for culture on Chrom ID ESBL- Bx agar and MacConkey agar. Antibiotic Susceptibility testing of ceftazidime and cefotaxime was done by Kirby-Bauer disc diffusion method and conformation of ESBL production by DPT using Clinical and Laboratory Standards Institute (CLSI) method. The Statistical Package for the Social Sciences (SPSS) Statistical package version (18.0) was used. Results: A total of 56 (80%) isolates were obtained from 70 urine samples, out of them 28 (50%) were Escherichia coli, 21 (37.5%) were Klebsiella spp., 7 (12.5%) were Proteus spp., 23 (82.14%) isolates of Escherichia coli, 15 (71.43%) of Klebsiella spp., 6 (85.71%) of Proteus spp., isolated were screened positive using Chrom ID ESBL-Bx agar. About 44 (78.57%) of total Enterobacteria (56) were screened for ESBL production. 20 (86.96%) of Escherichia coli, 11 (73.33%) of Klebsiella spp., and 5 (83.33%) of Proteus spp., that were screened positive using Chrom ID ESBL agar were confirmed (by DPT) as ESBL producers and 2 (16.6%) of total (12) isolates that were screened negative by Chrom ID ESBL agar were confirmed as ESBL producers when screened and confirmed by DPT. So sensitivity and specificity CHRO Magar was 94.73% and 55.5%. Conclusion: ESBL continues to become a serious public health threat. Results from present study showed that CHROMagar ESBL has a high sensitivity and a convenient method for making provisional diagnosis of drug resistant Enterobacterial infections in 24 hours. Chrom ID ESBL- Bx agar medium allows easy differentiation of different bacteria based on colony colouration.