PURPOSE: Multidrug-resistant organisms causing community-acquired and hospital-acquired infections are increasing at a dangerous rate. Carbapenemase-producing Enterobacteriaceae and Pseudomonas species are an important source of concern since these organisms are not only resistant to beta-lactam antibiotics but also show cross-resistance to other groups of antibiotics. In the present study, rapid detection of these carbapenemase-producing Enterobacteriaceae and Pseudomonas species by carbapenemase Nordmann–Poirel (Carba NP) test was evaluated by comparing with modified Hodge test (MHT). MATERIALS AND METHODS: Imipenem-resistant Enterobacteriaceae and Pseudomonas species isolated from various samples such as pus, blood, sputum, urine, and endotracheal aspirates were processed for carbapenemase detection by MHT and Carba NP test. Kappa analysis was done to evaluate the percentage agreement between the two tests. RESULTS: Seventy imipenem-resistant Enterobacteriaceae and Pseudomonas isolates were analyzed in the present study for carbapenemase production. 63.41% ofEnterobacteriaceae and 34.48% of Pseudomonas species were carbapenemase producers considering both the methods. By MHT, 36 (51.42%) isolates and, by Carba NP test, 35 (50%) isolates were positive for carbapenemase production out of the 70 isolates. CONCLUSION: Carba NP test when compared to MHT is a simple, rapid, cost-effective biochemical test which can be used in all laboratories in the identification of life-threatening carbapenemase-producing Gram-negative bacteria.

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Biofilm formation helps the microbes to escape host defenses and develop resistance against antimicrobial agents. Early detection of slime production by the Candida species may direct the clinical management. The study was taken with the aim to estimate biofilm formation by Candida species in indwelling catheters and to compare three methods i.e. Congo red agar (CRA) method, Tissue culture plate (TCP) method, and tube method (TM). In this study, we evaluated the reliability of these methods in order to determine most suitable screening method and noted the sensitivity pattern of these isolates with the help of Vitek-2. Our data indicates that the TCP is an accurate and reproducible method for screening and can serve as a reliable quantitative tool for determining bio film formation by clinical isolates of Candida species along with susceptibility testing to reduce resistance pattern.

Staphylococcus aureus (S.aureus) and coagulase negative Staphylococci (CONS) are the commonest pathogens that lead to severe bacterial infections. It is a bacterium with consistent resistance development against commonly used antibiotics, with emergence of Methicillin resistant staphylococcus aureus (MRSA) causing several infections in patients following hospitalization. Glycopeptides like vancomycin is used as primary drug for treating infectious diseases caused by MRSA. Due to indiscriminate use of vancomycin to treat MRSA, several strains with variable susceptibility to the same have emerged. Evaluation of Vancomycin Minimum Inhibitory Concentration (MIC) in the MRSA isolates obtained from clinical samples received in the diagnostic microbiology laboratory. About 120 Staphylococci obtained from different clinical samples in the diagnostic Microbiology laboratory, at tertiary health care center, South India, were included in the study. The isolates were identified and susceptibility to the relevant antibiotics was done by Vitek 2 an automated system. Vancomycin MIC was detected by Vitek 2 and E-test strip technique. Out of 120 Staphylococcal strains, 79(65.8%) S. aureus and 41(34.1%) CONS were isolated. Methicillin resistance was observed in 38 (48.1%) strains of S. aureus. Almost all 38 MRSA isolates were vancomycin sensitive with MIC range of 0.5-2µg/ml. Maximum isolates had MIC of 1 µg/ml i.e. 65.78% and 71% by E-Test and Vitek 2 respectively. The reported increased MIC of Vancomycin, though within the susceptible range, might experience poor clinical outcomes. Emergence and spread of resistance to glycopeptides like vancomycin needs to be kept in check by rapidly detecting the strains for resistance and strictly obeying the infection control practices.

Nocardiosis is an acute, subacute or chronic bacterial infection caused by several species of geophilic aerobic bacteria of the genus Nocardia. Cutaneous nocardiosis is an uncommon infectious disease that presents as primary cutaneous infection or as a sequale of disseminated pulmonary nocardiosis. Its rarity and as nocardiosis is not an AIDS defined disease it is often underreported. The global incidence of cutaneous nocardiosis is not exactly known. The frequency of nocardiosis in HIV patients has increased from 0.3 to1.85%. In Immunocompetent persons Primary Cutaneous Nocardiosis is more commonly seen among gardeners and agriculturists. We report a case of extensive primary facial cutaneous nocardiosis due to Nocardia asteroides, in an adult immunocompromised lady who had no pulmonary focus. The lesions were seen as sinus tracts on the zygomatic arch, preauricular and Infraauricular regions. Bacteriological examination of the pus confirmed the presence of N. asteroides. The rarity of the presentation and Cutaneous nocardiosis in India is reviewed.