The present study was conductedto determine the antibiotic susceptibility patterns of the organism isolated from patients with urinary tract infections (UTIs). This study was carried out in the Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Imphal, Manipur for a period of one year. A total of 946 mid-stream urine samples were collected, out of which 285 (30.13%) showed growth of bacteria with significant count. Escherichia coli 123(43.16%) was the commonest bacterial pathogen followed by Klebsiellapneumoniae 51(77.89%), Staphylococcus aureus 43(15.09%), Enterococcus species 26 (9.12%), Proteus species 18 (6.3%) Pseudomonas aeruginosa 14 (4.9%) and Coagulase negative Staphylococcus 10 (3.5%). Most of the strains of Escherichia coli, Klebsiellapneumoniae, Staphylococcusaureus showed resistant to ciprofloxacin and norfloxacin. Sensitivity was highest with gentamicin and netilmicin. Enterococcus, Proteus, Pseudomonas and Coagulase negative Staphylococcus showed resistant to cotrimaxazole and is sensitive to nitrofurantoin, gentamicin and netilmicin.

Introduction: Candidiasis is an opportunistic infection which occurs due to indiscriminate and prolonged use of broadspectrum antimicrobials, corticosteroids, immunosuppressive agents, diabetes mellitus, Human Immunodeficiency Virus (HIV), chronic renal failure, haemodialysis, renal transplantation or indwelling urinary catheter. Recently, Non-albicans Candida (NAC) species have replaced Candida albicans and emerged as an important opportunistic pathogens exhibiting decreased susceptibility to commonly used antifungal agents. Early speciation of Candida isolates along with their antifungal susceptibility testing not only will restrict the empirical use of antifungal agent but also greatly influence the treatment options for the clinicians. Aim: To speciate Candida isolates from various clinical specimens and to determine their antifungal susceptibility pattern. Materials and Methods: This study was a cross-sectional study carried out in the Mycology Section, Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Imphal, Manipur, India, from September 2016-August 2018. Candida isolates were identified using standard microbiological procedures, and speciation was done following conventional and HiCrome differential media. Antifungal susceptibility testing was determined by using Clinical and Laboratory Standards Institute (CLSI) disk diffusion method. Data analysis was done using descriptive statistics and Chi-square test. Results: A total of 100 isolates were identified from different clinical specimens, which included 43 (43%) from sputum, 34 (34%) from urine, in majority. Highest age was 92 years and lowest age was one year from whom the isolates were detected and females (57%) outnumbered males (43%) patients. Predominant Candida isolates were Candida albicans (44%), Candida tropicalis (32%). Among the azoles, the most sensitive agent was voriconazole (86%) and least was ketoconazole (56%), 81% of the total isolates were found sensitive to amphotericin B. Conclusion: The present study demonstrated that NAC spp. have surpassed Candida albicans and there is an increase in the resistance of the Candida isolates to commonly used antifungal agents. Therefore, this study highlights the need for speciation of Candida isolates upto species level and to determine the antifungal susceptibility pattern to decrease the morbidity and mortality of the patients.

BACKGROUND Onychomycosis is a fungal infection of the nails. It is caused by dermatophytes, non-dermatophytes and yeasts. In spite of improved personal hygiene and living condition, it continues to persist and poses a major clinical challenge regarding its treatment due to its chronicity. The present study was conducted to identify the fungi causing onychomycosis in our region. MATERIALS AND METHODS This descriptive study was carried out in the Department of Microbiology at a tertiary healthcare centre in Manipur from August 2016 to August 2017. A total of 166 cases of clinically diagnosed cases of onychomycosis were taken up for study. After disinfecting the nails with 70% alcohol, collected nail samples were subjected to 20% KOH and culture was done on Sabouraud's Dextrose Agar (SDA) with chloramphenicol. Identification of the isolates was done by microscopic and macroscopic examination. RESULTS Out of 166 samples KOH is positive in 54 samples (32.54%), of which culture is positive in 30 samples (18.07%) and 24 is culture negative (14.45%). Total culture positivity is seen in 52 samples (31.32%), of which 30 samples (18.07%) is KOH positive and 22 samples (13.25%) is KOH negative. Females are predominantly affected (64.45%). F: M is 1.8: 1. Most affected age group is 21-30 yrs. (30.12%). Candida species are the commonest species isolated (46.15%) and non-albicans Candida are more predominant (30.76%) followed by dermatophytes (28.84%). Trichophyton rubrum is the commonest dermatophyte isolated (15.38%). CONCLUSION The study showed the genus Candida as the main pathogen causing onychomycosis in our region. So, clinical onychomycosis should be confirmed both by KOH and fungal culture to prescribe specific antifungal drugs for optimal outcome.

BACKGROUND Dermatomycoses constitute more than 50% of cases in Dermatology outpatient department, which do not require compulsory notifications, but rather cause cosmetic defacements. Indian subcontinent is favourable for various fungal infections. The objective of this study is to identify the aetiology of fungal infections of skin, nail and hair in patients attending tertiary care centre in north east India. MATERIALS AND METHODSA total of 160 samples from clinically suspected dermatomycoses were collected. Direct microscopy in 10% KOH (potassium hydroxide) and culture on (Sabouraud's dextrose agar) SDA containing gentamicin (5 gm/L) and chloramphenicol (50 gm/L) were performed. RESULTSOut of the 160 samples, 95 cases were positive on direct KOH mount and 108 were culture positive. In 64 cases, both KOH and culture were positive. Maximum number of cases belonged to the age group of 31 -40 years. Males were more affected compared to females. Most common isolates obtained in our study were yeasts followed by dermatophytes and non-dermatophytic moulds (NDMs). Candida albicans (25%) was the most common yeast isolated. Among the dermatophytes, Trichophyton mentagrophytes was the commonest and among the non-dermatophytic moulds (NDMs), Aspergillus niger was the most frequent. CONCLUSIONOur study reflects an increasing role of yeasts as a causative agent of dermatomycoses replacing the dermatophytes. KEYWORDSDermatomycoses, Dermatophytes, Yeasts, Non-Dermatophytic Moulds. HOW TO CITE THIS ARTICLE: Chongtham U, Preeti G, Singh HL. Mycological pattern of dermatomycoses in a tertiary care centre in North East India. J. Evolution Med. Dent. Sci. 2018;7(11):1373-1375, DOI: 10.14260/jemds/2018/312 BACKGROUND Dermatophytes are a group of closely related fungi capable of invading keratinised tissues such as the skin, hair and nails causing infections referred to as dermatophytosis. Epidemiological studies showed that this pathology is among the most prevalent in the world and is considered the second most common skin disease in the adult population. It is estimated that 10% -15% of the general population may be affected by these microorganisms at some time in their lives. 1 Dermatophytic infections are of major importance, as they are widespread and cause discomfort and aesthetic problems. Reactions to dermatophyte infection may range from mild to severe. The severity depend on a variety of factors such as the host reactions to the metabolic products of the fungus, the virulence of infecting species or particular strain, anatomical location of the infection and local environmental factors. 1 Dermatophytic infections are a common clinical problem encountered in more than 50% of patients attending the 'Financial or Other Competing Interest': None. Submission 02-02-2018, Peer Review 28-02-2018, Acceptance 05-03-2018, Published 12-03-2018. Corresponding Author: Gurumayum Preeti, Keishampat, Keisham Leikai, Imphal West, Manipur. E-mail: preetigurumayum@gmail.com DOI: 10.14260/jemds/2018 dermatology outpatient dep...

Introduction: Coagulase Negative Staphylococci (CoNS) are common opportunistic pathogens. They are increasingly being recognised as nosocomial pathogens and are associated with multiple antimicrobial resistance mechanisms particularly methicillin resistance. Therefore, rapid and reliable identification upto the species level is necessary to predict the potential pathogenicity or antibiotic susceptibility of each clinical isolate. Aim: Isolation and speciation of CoNS from various clinical samples, and to determine their antibiotic susceptibility pattern. Materials and Methods: This study was a hospital-based crosssectional study carried out in the Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Imphal, Manipur, India, during the period from September 2017- August 2019. CoNS isolates were identified using conventional microbiological procedures and speciation was done following the scheme of Kloos and Schleifer. Antibiotic susceptibility was determined by using the Kirby Bauer’s disk diffusion method. Detection of methicillin resistance among CoNS was performed using cefoxitin disk (30 µg) diffusion method. Data analysis was done using descriptive statistics. Results: CoNS isolates were identified from different clinical specimens, which included 88 (65.2%) from urine, 37 (27.5%) from blood, 3 (2.2%) from pus, 2 (1.5%) from catheter tip, 2 (1.5%) from wound swab, 1 (0.7%) each from aural swab, sputum and ascitic fluid. Predominant isolates were Staphylococcus epidermidis (40.7%) followed by Staphylococcus haemolyticus (19.3%), Staphylococcus hominis (11.9%), Staphylococcus xylosus (7.4%), Staphylococcus saprophyticus (6.0%), Staphylococcus schleiferi (5.2%), Staphylococcus simulans (4.4%), Staphylococcus warneri (3.0%), Staphylococcus lugdunensis (0.7%), Staphylococcus capitis (0.7%) and Staphylococcus cohnii (0.7%). Most isolates were resistant to penicillin (84.5%) and erythromycin (59.3%), and least to tigecycline (2.2%). No resistance to vancomycin and linezolid was seen. Methicillin sensitive CoNS (MSCoNS) was detected in 79 (58.5%) isolates and methicillin resistant CoNS (MRCoNS) in 56 (41.5%) isolates. Conclusion: This study demonstrated the occurrence of various species of CoNS in our healthcare set up with varying antimicrobial susceptibility pattern. Therefore, there is a need for accurate identification to species level by simple, inexpensive methodology and their antibiogram.