A good clinical acumen supported by the basic investigations can help diagnose the cause of fever with reasonable certainty.

Background: Serratia spp. is a common enteric bacterium generally thought not to be pathogenic in the gastrointestinal tract. Serratia marcescens is a member of the genus Serratia, which is a part of the family Enterobacteriales..Of all Serratia species, S. marcescens is the most common clinical isolate and the most important human pathogen. Objective: We are discussing here four cases of Serratia marcescens which we reported in our laboratory in the Department of Microbiology Government Medical College and Hospital Chandigarh during six months of duration. Method: All the samples were processed and identified as per standard microbiological techniques.The isolates of Serratia marcescens were identified, depending upon their biochemical and morphological characters and further confirmed by MALDI-TOF-MS ,PGIMER Chandigarh. Result: In one of the four cases there was polymicrobial infection and one patient was diabetic and rest three patients were immunocompetent. The importance of detection and reporting of Serratia marcescens is related to the concern regarding its increase spread in hospital settings as nosocomial infection . Conclusion: We need to identify and isolate this pathogen ,not thinking of only contaminant and opportunistic pathogen but as a pathogen which can lead to serious infections in hospital settings .

Objective: Source of infection in a burn patient is from the patient’s own flora, contaminated environmental surfaces and from health care workers. Insufficiently disinfected hospital environmental surface provides a niche for multidrug resistant bacteria. This study was done to assess the bacteriological profile of the pathogens from burn wound and the surrounding environmental areas. Method: During 6 months wound swabs from burn patients were collected on admission (after 48 hours of admission), on day 5 and then weekly. Environmental samples were also collected from burn ward and studied for the bacteriological and anti-microgram profiles. Results: Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii were the major bacterial isolates from the woundswabs and from theenvironmental samples. ESBL was detected in 56.6% of our Enterobacteriaceae isolates. The environmental sites from which these bacterial isolates were found were nursing counter, sink, dressing trolley, medicine locker and patient’s bed. The percentage of MRSA has decreased from 50 to 5% and there is increased role of Enterococci species causing infections (13.63%). Conclusions: In this study, there appears that the colonizers of the environment may play a role in causationof infection in burn patients.In burns ward, rigorous implementation of infection control program should be warranted, which includes and hygiene and use of personal protective equipment, environmental disinfection, cohort nursing care and antibiotics stewardship programme.

Introduction: The members of the tribe Proteeae, Morganella and Providencia are being increasingly recognized as important pathogens. The spectrum of disease caused by them is wide and in reported cases the mortality is high. Previously both these pathogens were considered to be rare pathogens as the potential to cause nosocomial transmission and infection was not much studied. But their phenomenal evolution and increase in multidrug-resistance (MDR) strains of these pathogens are posing a major threat toward public health throughout the world. Material and Methods: This present study was carried out from July 2018 to December 2018 on all the pus and body fluid samples that were received in Department of Microbiology. Samples were processed as per standard Microbiological guidelines and alsowere analyzed for their antimicrobial susceptibility profile as per Clinical Laboratory Standards Institute. Results: Out of 8425 samples received, 2140 were culture positive, amongst which 19 samples (0.89%) were positive for Providencia species (9) and Morganella morganii(10). The male : female ratio of these 19 patients was 2.8 : 1 and maximum patients (13) belonged to 20-60 years.As far as risk factors are concerned, maximum patients were diabetics (7) followed by abnormal liver function tests(6),concomitant UTI (6), history ofinvasive procedure (5), prior exposure to antibiotics (5) and urinary catheterization (4). About 6 were polymicrobial infections.Antibiotic susceptibility patterns revealed that Providencia strains were sensitive to ampicillin- sulbactum (77.7%) and amikacin (77.7%) while all Morganella strains were 100% sensitive to tobramycin and piperacillin tazobactam. Conclusion: This study heralds in a need for more research in this area as infections caused by these two pathogens are on the rise.Moreover,resistance to antimicrobials is also an increasingly common problem thus delaying the treatment and prognosis of disease.