Diabetic foot problems such as ulcerations, infections and gangrene are dreadful complications of diabetes mellitus and a major cause of hospitalization. Overall 15% of individuals with diabetes mellitus will have foot ulcers during their lifetime. Diabetic foot infected patients are usually prescribed with broad spectrum antibiotics. Our study was done to evaluate the sensitivity pattern of cephalosporins in diabetic foot patients and to assess their prescribing patterns. We carried out a prospective study in the surgery department of a tertiary care hospital on 77 patients who had diabetic foot infections. Prescribing patterns of cephalosporins and wound culture and sensitivity testing on these patients was studied for a period of 6 months. Staphylococcus aureus was the most common gram positive pathogen isolated, E.coli, Klebsiella, Pseudomonas and Citrobacter were the common gram negative organisms isolated. Ceftriaxone was the most commonly prescribed antibiotic. Sensitivity pattern showed that 41.5% of gram positive cocci and 25% of gram negative bacilli were sensitive to Ceftriaxone. Ceftriaxone in our study was found to be an effective drug provided appropriate barrier techniques were used to prevent nosocomial spread. Organisms which were originally sensitive developed resistance approximately in a span of two weeks, probably due to antibiotic pressure. Hence there should be an active infection control team which can monitor the prevalent organisms and their antibiograms and periodically inform the clinicians. The pharmacists should also be included in the team, apart from the microbiologist, the surgeon and the nursing staff.

Streptococcus salivarius is a rare cause of infection in neonate .It is a commensal organism in the oral cavity. Though commensal it can cause invasive infection in immune compromised patients. We report blood stream infection with streptococcus salivarius in a neonate with pneumonia. The blood stream infection was considered significant and treated.

Abstract:Background: Burn patients are at high risk of infection, and it has been estimated that over 75% of all deaths following burns are related to infection. It is therefore, essential to determine the specific pattern of burn wound colonization and their antibiotic susceptibility profiles. Aim: To study the prevalence of various aerobic bacterial isolates in burns wound infection, evaluate antibiotic susceptibility profile of these bacterial isolates and to detect multi-drug resistant (MDR) strains among these isolates. Materials and Methods: This descriptive cross sectional study was conducted in the Department of Microbiology of Jubilee Mission Medical College and Research Institute, Thrissur over a study period of one year and six months. 110 non-repetitive samples from burns cases were included in the study by consecutive sampling. Samples were processed as per standard microbiological methods and were identified using biochemical reactions and antibiotic susceptibility tests were done. Results: Cultures from burn wound revealed Pseudomonas aeruginosa as the most common organism isolated followed by Acinetobacter baumannii, Staphylococcus aureus, Klebsiella spp., Escherichia coli and Enterobacter cloacae. Majority of the isolates were multi-drug resistant. Multi-drug resistance was shown by 86.11% of Acinetobacter baumannii followed by E. coli and Klebsiella spp. Pseudomonas aeruginosa showed differing trend (24%) in terms of multi-drug resistance when compared to many previous studies. A high proportion of ESBL and carbapenemases were detected among our study isolates. Positivity for MBL and ESBL were shown by 77.77% and 58.33% Acinetobacter baumannii respectively. ESBL production was positive for 50 % of E. coli and 42.85% of Klebsiella spp. Among Pseudomonas aeruginosa, 12% tested positive for ESBL and 18% for carbapenemases. Among Staphylococcus aureus, 42.30% were MRSA. Conclusion: The results of the present study will be helpful in understanding the pattern of burn wound microbial infection, the dominant bacterial flora and the antimicrobial resistance.