(Background) Numerous reports on carbapenem resistance in different parts of India have been published, yet there are insufficient studies on the prevalence of antibiotic resistance in the northeast region of the country. This study evaluated the emergence of carbapenem resistance in the clinical isolates collected in Mizoram. (Results) A total of 141 Gram-negative clinical isolates were collected from the two hospitals, including the Civil Hospital in Lunglei and the Synod Hospital in Aizawl. The isolates include Escherichia coli (n = 62, 43.9%), Klebsiella spp. (n = 43, 30.4%), Pseudomonas aeruginosa (n = 9, 6.3%), Serratia marcescens (n = 3, 2.1%), Proteus mirabilis (n = 2, 1.4%), Shigella spp. (n = 4, 2.8%), Enterobacter spp. (n = 6, 4.2%) and Acinetobacter spp. (n = 12, 8.5%). The isolates were found to be resistant to meropenem (11%), colistin (48%), tigecycline (25%) and cefotaxime (50%). A total of four E. coli and one Shigella sonnei encoded the blaOXA-48-like gene. The blaCTX-M-1 gene was detected in 13 isolates, of which eight were E. coli, two Shigella flexneri, and one isolates each of K. pneumoniae, K. oxytoca and Shigella sonnei, respectively. (Conclusion) Carbapenem-resistant Enterobacteriaceae are common among other parts of India, despite limited access to antibiotics, the emergence of resistance in the northeastern region is worrying.

Objective: Differentiating scrub typhus from other acute febrile illnesses is difficult due to non-specificity of clinical symptoms and relative absence of eschar in Indian population. Antibody based serological tests are mainstay of scrub typhus diagnosis. To order to determine the performance of immunochromatography and IgM ELISA, immunochromatography and scrub typhus IgM ELISA were performed to detect the presence of antibodies against Orientia tsutsugamushi in acute serum of patients with acute febrile illness.

Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, a gram-negative intracellular bacterium. It is a severe public health problem that affects mainly Asia-Pacific areas. Scrub typhus threatens one billion people and causes illness worldwide each year. Approximately one-third of the cases may suffer from multiple organ dysfunction syndrome (MODS) during the disease course. Thrombocytopenia is another critical clinical manifestation of scrub typhus, and thrombocytopenia is one of the causes of MODS. Scrub typhus is rare and hard to diagnose and treat. Given the close similarity in the clinical presentation of several tropical illnesses, a meticulous history and detailed physical examination need to be emphasized. In this study, we reported a case of scrub typhus with thrombocytopenia and MODS, which is only the third case worldwide.

Healthcare associated infections are important cause of patient morbidity and mortality. Microbiological contamination of air and environment in the operation theatres (OTs) are major risk factor for surgical site and other hospital-associated infections. To identify bacterial colonization of surfaces, equipments and to determine the microbial contamination of air in the OTs of a tertiary care hospital in Lunglei, Mizoram which is in north eastern part of India. Four years (January 2016 – December 2020) retrospective analysis of a data obtained from routine microbiological surveillance of the OTs. Surface samples were taken with wet swabs from different sites and equipments, and Settle plate method for air in the OTs. Bacterial species were isolated and identified by conventional method. The colony forming unit (CFU) count/plate was expressed as CFU/m3 by Omeliansky formula. The culture positivity rate of surface swab samples was 6.4% (60/937). Bacillus spp. with 45 (67.16%) isolates was the most common baterial isolates. The bacterial CFU/m3 counts of air in the two OTs were in the range of 90 to 166 before fumigation. Staphylococcus aureus with 43(42.16%) was the predominant species obtained and the least common species obtained was Enterococcus faecalis with13 (12.74%). The bacterial CFU/m3 counts of air was one in both the OTs after fumigation. Settle plate method for air and swabbing technique for surfaces are proved to be valuable techniques in detecting the contamination level in our set up with limited resources.