The prevalence of Enterobacteriaceae strains producing MBL type carbapenemase in our health care setup is 5.75% (19/330). None of the strains among the carbapenem-resistant bacterial isolates showed production of KPC enzyme. The need of the hour is simple, rapid and cost effective tests which will be able to identify and distinguish resistant pathogens for improved patient outcome, facilitating efficient infection control and reducing the escalation of resistance.

Objectives: This study was undertaken to compare the results of laser (Ho:YAG) and pneumatic (ballistic) intracorporeal lithotripsy for ureteric calculi in terms of efficacy, safety and complications. Methods: 55 patients having ureteric calculus were randomly allocated into pneumatic lithotripsy (PL) and laser lithotripsy (LL) groups. Swiss lithoclast was used for PL (3 atm pressure and 12 Hz frequency) and the VersaPulse PowerSuite was used for LL. Appropriate statistical tests were applied. Results: 30 patients (34 stones) were treated with LL and 25 patients (25 stones) with PL. Both groups were comparable in profile. Mean lithotripsy time was 24.03 ± 9.51 min in the LL group and 19.80 ± 4.44 min in the PL group (p = 0.027). The immediate stone clearance rate was higher in the LL group (p = 0.001), but it was comparable at 4 weeks (p = 0.097). Stone migration occurred in 16% of cases in the PL group. No major complication was observed in either group. Conclusions: We conclude that both laser and pneumatic energies are effective and safe for intracorporeal lithotripsy. Laser lithotripsy takes more time but provides earlier stone-free status.

SUMMARY: Proteus mirabilis strains that produce extended-spectrum b-lactamase (ESBL), AmpC blactamase, and carbapenemase pose potential threats to patient care because most clinical diagnostic laboratories may not attempt to detect these three major groups of enzymes. Therefore, the objective of this study was to ascertain if P. mirabilis isolates collected from our heathcare facility possess various mechanisms of resistance to b-lactams (i.e., ESBL, AmpC, and carbapenemases) and to additionally arrive at conclusions regarding concurrent testing for these three mechanism of drug resistance in order to reduce cost and time in routine diagnostic testing. Between January 2011 and June 2011, 60 consecutive non-repeated strains of P. mirabilis were evaluated for production of ESBLs, AmpC b-lactamases, and carbapenemases. Of these, 36 isolates were found to be ESBL producers, and 7 (12z) were positive for production of AmpC b-lactamases and ESBLs. Therefore, 19.4z of ESBL-producing Proteus strains coproduced AmpC enzymes. The modified Hodge test confirmed carbapenemase production in only 1 isolate (1.7z), which was also ESBL-and AmpC-positive. The clinical impact of additional AmpC expression in ESBL-producing P. mirabilis results in a newly acquired resistance to b-lactamase inhibitors. In addition, to save time and costs, we recommend the use of cefepime/cefepime-clavulanate or boronic acid for the ESBL detection but in only those strains that were positive for ESBL by screening and negative by confirmatory tests.

Linezolid is being increasingly used in the treatment of infections with gram-positive organisms especially methicillin resistant Staphylococcal isolates. Though resistance to this antimicrobial is emerging but it is extremely rare. Here we document first case of linezolid resistant Staphylococcus haemolyticus (S.haemolyticus) from India. This organism was isolated from pus oozing from a postsurgical site in 61 year old male hailing from an adjoining state of Haryana.

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