INTRODUCTIONPseudomonas aeruginosa is an aerobic, motile, nutritionally versatile, gram negative bacteria. It is ubiquitous, human opportunistic pathogen and has implications on morbidity, mortality and healthcare costs both in hospitals and in the community.1 Infections caused by P. aeruginosa are frequently life-threatening and difficult to treat causing increased stay in hospital and even increased morbidity and mortality as it exhibits intrinsically high resistance to many antimicrobials and the development of multi-drug resistance in health care settings.2,3 Biofilms are defined as microbially derived sessile communities characterized by the cells that are irreversibly attached to a substratum or to each other. They are embedded in a matrix of extracellular polymeric substances (EPS) they have produced, and exhibit an altered phenotype with respect to growth rate and gene transcription.4 Within a biofilm, bacteria communicate with each other by production of chemotactic particles or ABSTRACT Background: Pseudomonas aeruginosa is an ubiquitous pathogen capable of surviving in a variety of environmental conditions. It is increasingly gaining importance as a multidrug resistant nosocomial pathogen. Biofilm acts as a barrier, reducing the penetration of these drugs and consequently, preventing them from exercising their actions. The aim of this study is to isolate and identify Pseudomonas aeruginosa from various clinical specimen and to find out their production of biofilms and their correlation with antibiotic susceptibility pattern. Methods: All Pseudomonas aeruginosa over a period of 1 year were isolated and identified from clinical specimens and antibiotic susceptibility test was done following standard operative procedures. Biofilm detection was done by Congo Red Agar method (CRA). Results: 134 isolates of Pseudomonas aeruginosa was isolated. Maximum isolates were isolated from sputum samples 55 (41%) and most were from wards 68 (51%) giving a probability of increased healthcare associated infections. Biofilm production by the isolates was seen in 39 (29%). All the biofilm producing isolates shows more resistant pattern in comparison to non-biofilm producers. 69% of Imipenem and 82% of Meropenem resistant isolates produce biofilm. All the P. aeruginosa including MDR and biofilm forming strains were sensitive to Colistin. Conclusions: Resistance to antimicrobial agents is the most important feature of biofilm infections. Ability of P. aeruginosa to form biofilms renders antibiotic treatments inefficient and therefore promotes chronic infectious diseases. As a result, infections caused by bacterial biofilms are persistent and very difficult to eradicate.

Background: Urinary tract infections are one of the major health problem effecting both sexes of all age group. UTIs are often treated with different broad-spectrum antibiotics. The aim of this study was to determine the prevalence of bacteria causing urinary tract infections and their susceptibility pattern from patients reporting in RIMS Hospital.Methods: Mid stream urine (MSU) specimens sent to the laboratory from October 2014 to September 2016 were collected and inoculated onto blood agar and MacConkey agar and incubated at 37ºC for 24 hours. Identification and antibiotic susceptibility test was done following standard operative procedures.Results: 25.66% (1142/4450) samples showed a significant growth out of which 42% (479/1142) were male and 58% (663/1142) were female. E. coli has been found to be the major pathogen causing UTI which account for 61% (696/1142) followed by Staphylococcus aureus 12% (137/1142), CONS 7% (79), Enterococcus spp. 6% (67), Klebsiella spp. 5% (57), Proteus spp. 2% (22), Pseudomonas spp. 2%, Acinetobacter spp. 2% and Candida spp. 3%. Imipenem was the most susceptible antibiotic for Enterobacteriaceae, E. coli (85.9%), Klebsiella spp. (89.4%) and Proteus spp. (95.4%). Vancomycin is 100% sensitive while Linezolid, Nitrofurantoin and Gentamicin are also highly sensitive for both Staphylococcus aureus and CONS.Conclusions: These data may be used to determine trends in antimicrobial susceptibilities, to formulate local antibiotic policies in order to assist clinicians in the rational choice of antibiotic therapy to prevent misuse, or overuse, of antibiotics.

Background: Acinetobacter is an important opportunistic pathogen and is a common cause of hospital acquired infections. Acinetobacter infections are often extremely difficult to treat because of their widespread resistance to the major groups of antibiotics. The study was conducted to determine prevalence and antibiotic susceptibility pattern of Acinetobacter species isolated from various clinical samples.Methods: Clinical specimens over a period of 2yrs from May 2015 to April 2017 were collected from the patients attending the hospital. Acinetobacter species isolates were identified, and antibiotic susceptibility test was done following standard operative procedures.Results: From 9979 clinical specimens, 3715 were positive for significant bacterial growth of which 111 (2.9%) were culture positive for Acinetobacter spp. Among 111 isolates 109 (98.2%) isolates were Acinetobacter baumanni and 2 (1.8%) were Acinetobacter lwoffii. Maximum isolates were isolated from urine samples 36 (32.4%) and majority of the isolates were from wards (56.7%) giving a probability of increased hospital acquired infections. Maximum resistance was shown by cefipime (80.1%). Imipenem and Meropenem shows resistance of 25.3% and 29.7% respectively. ICU isolates showed extensive resistance in comparison to wards and OPD.Conclusions: Increasing trend of resistance pattern to a large range of antibiotics is a matter of concern. To avoid resistance, antibiotics should be used judiciously, and empirical therapy should be determined for each hospital according to the resistance rates of the hospital. Infection with MDR Acinetobacter species is independently associated with high mortality, emphasizing the need for aggressive infection control strategies.

Background: Urinary tract infection (UTI) is one of the commonest health problem encountered in clinical practice. The biofilms play major role in decreasing the susceptibility to the antimicrobial agents. The present study aimed at isolation and identification of Escherichia coli from cases of urinary tract infection, and to find out production of biofilms by these isolates and to correlate it with antimicrobial resistance.Methods: This study was a cross sectional study. Urine specimen from patients suspected of UTIs were collected and processed by standard operative procedure, antibiotic susceptibility test was done by Kirby Bauer disc diffusion method. Biofilm production in isolates was done by Tissue culture plate (TCP) method, Christensen’s test tube (CTT) method, and Congo red agar (CRA) method.Results: Out of the total of 250 isolates 191 (76%) showed biofilm positive by TCP method, 180 (72%) showed biofilm positive by CTT method, 161 (64%) showed biofilm positive by CRA method. 90% of total extended spectrum beta lactamase (ESBL) producing Escherichia coli were biofilm producers. There is more resistance for each and every antibiotic among biofilm producers in comparision to biofilm non producers.Conclusions: The microbial biofilms may pose a public health problem, as the microorganisms in the biofilms are difficult to be treated with antimicrobial agents.

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