Introduction:In last few years, Gram-negative bacilli are isolated capable of producing various classes of carbapenemases with ability of hydrolyzing the β-lactam antimicrobial. Carbapenem Resistant Enterobacteriaceae (CRE) have been reported worldwide. There is a serious threat to public health due to the emergence and rapid spread of CRE. Aims: To find prevalence and bacterial profile of CRE in clinical isolates in indoor patients from a rural tertiary care centre. Materials and Methods:The study was conducted in a tertiary care teaching hospital in Western India, June 2016 to April 2018. The clinical specimens received in microbiology laboratory were processed by the standard method. Bacteria were identified by VITEK 2 compact (Biomerieux) automation system, and antimicrobial susceptibility testing was done with the same system to detect minimum inhibitory concentrations for carbapenem group of antimicrobials. CLSI 2016 guidelines were used to detect CRE. Results: Total 535 Enterobactericaeae clinical isolates were included in the study. Of these, 31.77% (n=170) were CRE. Specimens like urine, pus/ wound swab and endotracheal tube secretion were the major contributors for CRE isolates.82% of CRE were Klebsiella pneumoniae (63%) and E.coli (19%). Conclusions: A high prevalence of 31.77% carbapenem resistance was observed among Enterobacteriaceae isolates. Early detection, isolation and contact precaution of CRE patients will help to prevent rapid dissemination of CRE infection.

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BACKGROUND: Pseudomonas aeruginosa is one of the leading causes of nosocomial as well as community acquired infections. Due to development of multi drug resistance (MDR), there are many therapeutic failures. The present study was carried out to find out the susceptibility pattern of the organism in this area. METHODOLOGY: From 2089 clinical specimens received over a period of six months, a total of 277 P.aeruginosa strains were identified and minimum inhibitory concentrations for various antibiotics was found out with help of automated method VITEK 2 (Biomerieux), RESULT: 75.81% P.aeruginosa isolated were MDR. Proportion of resistant strains varied from 38% to 75% to commonly used antipseudomonal antimicrobials groups like aminoglycosides, cephalosporins, carbapenems, fluoroquinolones, and anti-pseudomonal penicillins. Resistance to colistin was only15%. CONCLUSION: P. aeruginosa were less resistant to β lactam with β lactamase inhibitor combination therapy like cefoperazone /sulbactam and piperacillin/tazobactam. Colistin was most sensitive antibiotic. Prior information of susceptibility will be useful to reduce mortality and morbidity caused by P.aeruginosa.

Acute viral hepatitis(AVH) is caused by Hepatitis A (HAV) and Hepatitis E(HEV). It is major health burden in India. Both the viruses HAV and HEV are primarily transmitted via the faeco-oral course. Study was conducted to determine the seroprevalence of HAV, HEV and rate of co-infection in AVH patients attending rural tertiary care centre. A retrospective laboratory record based study was carried out in rural tertiary health care center located in Western Maharashtra. Laboratory and Medical records of suspected acute viral infection patients were analyzed during study. Study period was June 2014 to July 2018. Commercially available ELISA kits of IgM anti-HAV and IgM anti-HEV were used to analyze serum samples of suspected study participants. Tests were carried out as per the manufacturer’s instructions. A total of 778 acute viral hepatitis cases were included in the study from July 2014 to July 2018 among which 85/778 (10.9 %) detected positive for HAV and 121/778 (15.6%) detected positive for HEV. Co-infection was identified in 6/778(0.8 %). Jaundice, fever fatigue and hepatomegaly were common clinical presentation in HAV, HEV and confection with both viruses in acute viral hepatitis patients. Study indicated low exposure to HAV in childhood bellow 16 years. Co-infection rate was detected high in 16-25 years age group. Vaccination policy against HAV in adolescent age group needed as there is change epidemiological shift of HAV which has been observed in the current study. These data will helps for planning future vaccination strategies, better implementation sanitation program, and safe water supply in this geographic area.

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