Infection caused by drug resistance Klebsiella pneumoniae is very common now days in community as well as nosocomial environment. K.pneumoniae is second most common pathogen in neonatal septicemia. Our aim to detect drug resistance K.pneumoniae by production of β-lactamase enzymes such as extended spectrum β-lactamase (ESBL), AmpC β-lactamase, metalo β-lactamase (MBL) and carbapenemase in neonatal septicemia. A total 13 isolates of K.pneumoniae detected from neonates admitted in tertiary care centre during study period from February 2015 to July 2016. We analyzed risk factors in K. pneumoniae infection among neonates on the basis of prolong rupture of membrane, preterm birth, onset of septicemia etc. Antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion methods. β-lactamase enzymes includes, Extended spectrum β-lactamase(ESBL), AmpC β-lactamase, metalo β-lactamase (MBL)and carbapenemase were detected by phenotypic methods using standard guidelines. Distribution of MDR, XDR and PDR detected according to antimicrobial resistance pattern as per guideline. Among 13 K.pneumoniae isolate, antimicrobial resistance profile was studied. Isolates were 100% resistant to third generation cephalosporin and least resistant to imipenem 54%. MDR K.pneumoniae were 23 %, XDR were 77% and no PDR isolated. ESBL production seen in 23.1%, AmpC in 7.7 %, MBL in 00 % and Carbapenemase in 46.1 %. The study indicates that drug resistance higher in NICU of our institute. It requires strict implementation of infection control guidelines in NICU by safe hygiene practices, restricted use of broad spectrum antibiotics as empirical therapy and also formulation of uniform antibiotic policy for such patients based on the current trend of antibiotic resistance.

Klebsiella pneumoniae is an important opportunistic pathogen that commonly causes nosocomial infections and contributes to substantial morbidity and mortality. We sought to investigate the sensitivity pattern of K. pneumoniae isolated from various clinical specimens. Methods- This cross-sectional study was conducted at Ruxmaniben Deepchand Gardi Medical College and Ujjain Charitable Trust Hospital in Ujjain City during March 2021 to September 2021 on total 463culture positive isolates from various clinical specimens. Identification of K. pneumoniae and antibiogram testing were performed by using VITEK-2 compact bacterial identification and monitoring system (bioMerieux, US). The data were analyzed by using NCSS statistical software 2021. Results- In total, 83 positive K. pneumoniae cultures from various clinical samples were examined. The isolates were more predominant in the females (n = 45; 54.2%) compared to males (n = 38; 45.8%). The antibiotic resistance rate of K. pneumoniae varied among different isolate clinical sample sources. Overall, high resistance rates were recorded for ampicillin (100%), amoxyclav (81.48%),  piperacillin/ tazobactam (73.68%), cefuroxime (94.74%), ceftriaxone (91.2%), cefotaxime (91.2%),  and cefepime (73.68%). A total of 83 K. pneumoniae isolates, 75 were ESBL (90.36%) producers. However, colistin (100%) showed the highest susceptibility rate against the isolates. Conclusion- the wide variety of MDR K. pneumoniae harboring β-lactams and virulence genes strongly suggest a necessity for the implementation of effective strategies to prevent and control the spread of antibiotic resistant infections.

Background- Blood stream infection is a very important cause of morbidity and mortality worldwide, especially in resource limited countries. It ranges from transient bacteremia to life-threatening septic shock. Blood culture is a gold standard method of diagnosis of infectious agents present in the blood.Method- This study was conducted From August 2021 to October 2021 at Ruxmaniben Deepchand Gardi medical and Ujjain Charitable trust Hospital, Ujjain (M.P.). All received blood samples were processed, isolates were identified, and antibiotic susceptibility testing was performed using the Vitek 2 Compact (Biomerieux) system in the Microbiology laboratory.Results- A total of 74(17%) pathogens were isolated from 432 blood samples. Gram-positive bacteria 47(64%) were predominant organisms obtained, followed by gram-negative bacteria 25(34%) and non-albicans candida species 2(2.7%). The predominant pathogens were Staphylococcus aureus 40(54%), Klebsiella pneumoniae and Pseudomonas aeruginosa 6(24%) each. Among Staphylococcus aureus isolates 36 (90%) were methicillin-resistant Staphylococcus aureus (MRSA). And among gram-negative bacteria, all isolates of K. pneumoniae were extensively drug-resistant. Majority of drug-resistant organisms were isolated from neonatal intensive care unit (%).Conclusion- Successful treatment of bloodstream infection depends on early diagnosis and appropriate use of antimicrobial agents.

Aim: Infection caused by drug resistance Klebsiella pneumoniae is very common now days in community as well as nosocomial environment. K.pneumoniae is second most common pathogen in neonatal septicemia. Our aim to detect drug resistance K.pneumoniae by production of β-lactamase enzymes such as Extended spectrum β-lactamase (ESBL), AmpC β-lactamase, metalo β-lactamase (MBL) and carbapenemase in neonatal septicemia. Methodology: A total 13 isolates of K.pneumoniae detected from neonates admitted in tertiary care centre during study period from February 2015 to July 2016. We analyzed risk factors in K. pneumoniae infection among neonates on the basis of prolong rupture of membrane, preterm birth, onset of septicemia etc. Antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion methods. β-lactamase enzymes includes, Extended spectrum β-lactamase(ESBL), AmpC β-lactamase, metalo β-lactamase (MBL)and carbapenemase were detected by phenotypic methods using standard guidelines. Distribution of MDR, XDR and PDR detected according to antimicrobial resistance pattern as per guideline. Result: Among 13 K.pneumoniae isolate, antimicrobial resistance profile was studied. Isolates were 100% resistant to third generation cephalosporin and least resistant to imipenem 54%. MDR K.pneumoniae were 23 %, XDR were 77% and no PDR isolated. ESBL production seen in 23.1%, AmpC in 7.7 %, MBL in 00 % and Carbapenemase in 46.1 %. Conclusion:The study indicate that drug resistance higher in NICU of our institute. It requires strict implementation of infection control guidelines in NICU by safe hygiene practices, restricted use of broad spectrum antibiotics as empirical therapy and also formulation of uniform antibiotic policy for such patients based on the current trend of antibiotic resistance.

Mycetoma is a chronic, slow progressive granulomatous infection of skin and subcutaneous tissue; is classified into Eumycetoma (caused by fungi) and Actinomycetoma (caused by Actinomycetes). Fusarium, is a known cause of mycetoma. This case report describes the isolation and identification of Fusarium sp. from a lesion on the right foot of a female patient. This case report is about a 23-year-old female with complaints of gradual enlarging nodular swelling with multiple discharging sinuses along with granules on the right foot, on and off for last seven years. The granules obtained from the lesions are the best specimen for culture as they contain microcolonies of causative agents and it’s a hallmark of mycetoma. Granules were collected aseptically, crushed and examined microscopically on 20% KOH preparation. Plenty of thin hyaline, septate hyphae were seen. Granules were washed with sterile saline and inoculated on Sabouraud’s Dextrose Agar (SDA) and potato dextrose agar and incubated aerobically at 25°C and 37°C in two sets of each. Colonies grew at inoculated site, pinkish in the centre and whitish in the periphery. The isolate was identified as Fusarium sp. on the basis of morphology. The patient was started on Itraconazole 200 mg and is currently on the same treatment, improving and under follow-up. Mycetoma is a rare disease caused by both fungal and bacterial microorganisms. Definitive diagnosis should be made on the basis of culture or histopathological examination. Once the diagnosis is made, use of appropriate anti-fungal therapy with or without surgical interventions can result in complete cure without recurrence.