Introduction: Acinetobacter baumannii is a nonfermentative and nonmotile, Gram-negative coccobacillus, which is the most often identified pathogen among Acinetobacter species that causes wide range of infection in humans. It has emerged as one of the most troublesome pathogens for health care institutions globally. Acinetobacter baumannii strains resistant [multidrug-resistant A. baumannii (MDR-Ab)] to all known antibiotics have now been reported.

Bloodstream infection remains one of the most important causes of morbidity and mortality globally, specifically among intensive care unit patients. This prospective observational study included 887 blood culture samples collected cases admitted to intensive care unit suspected of having sepsis. Samples were cultured and evaluated for antimicrobial susceptibility patterns: 202 (22.78%) blood cultures were positive and yielded microbial growth with 132 (14.88%) having mono-microbial growth. Gram-negative bacteria accounted for 45.2% cases, with Escherichia coli being the most common; Gram positives accounted for 43.9% with Staphylococci haemolyticus being most common and 10.9% were fungal isolates. Gram-negative isolates were sensitive to colistin and tigecycline and 77.3% of isolates were extended spectrum beta-lactamase (ESBL) producers. Gram-positive isolates were sensitive to tigecycline, linezolid, vancomycin and teicoplanin with 97.5% being methicillin-resistant Staphylococci (MRSA). Most of the blood culture isolates from critically ill patients in intensive care unit were multidrug-resistant, ESBL producers and MRSA which raises a serious concern about the development of serious antibiotic resistance.

Introduction: Healthcare professionals have an important role in tackling the growing menace of Hospital Acquired Infections (HAI) and Antibiotic Resistance (ABR). Regular trainings imparted early in career can result in better understanding of these crucial issues. Aim: To identify the baseline Knowledge Attitude and Practices (KAP) of 5th semester MBBS undergraduate students of a University Medical College in Rajasthan, India, and to determine the changes in these parameters after the implementation of a vigorous “HAI and ABR Awareness campaign”. Materials and Methods: This prospective interventional study involved 86, 5th semester MBBS undergraduate students. The study instrument was a preformed pretested 30 item self-administered questionnaire. The study intervention included a series of lectures, role plays, poster competition; and an audio-visual quiz. The performance of individual participants before and after the intervention was then statistically analysed with Microsoft Excel and software Statistical Package for the Social Sciences (SPSS) version 20. Results: The pre-intervention overall KAP score of each student was found to be poor in 17.4%, average in 61.6%, and excellent in 20.9% in study participants. Post-intervention grades were found to be poor, average, and excellent in 1.1%, 8.14%, and 90.7% study participants, respectively. A statistically significant decrease in the percentage of students with poor grade and a significant increase in those with excellent grade were observed. Conclusion: There is a need for suitable amendments in current MBBS curriculum to include modules which comprehensively address the core issues of ABR, HAIs and Antimicrobial Stewardship (AMS). This would help to bring out attitude and behavioural changes in students at the very grass-root level.

Introduction: Lower Respiratory Tract Infection (LRTI) is one of the commonest health problems which is not a single disease but a group of specific infections with varying aetiology and symptomatology. These infections are the leading cause of illness and mortality in children and adults across the world because of different epidemiology, pathogenesis, clinical presentation, and outcomes. Aim: To find out the prevalence, bacteriological profile and antimicrobial susceptibility pattern of clinical isolates causing LRTI. Materials and Methods: This was a laboratory based observational study which was carried out between June 2019 to May 2020. All the lower respiratory tract samples (sputum, Endotracheal (ET) aspirate, Bronchoalveolar Lavage (BAL) etc.,) were collected and sample processing was done for isolation and identification by standard methods and antimicrobial susceptibility testing was done using Kirby Bauer disc diffusion method. The data was analysed in Microsoft Office excel worksheet. Results: A total number of 1364 samples were processed in which 615 were culture positive. ET aspirates 65.04% (n=400) showed higher positivity rate than sputum 32.03% (n=197). In this study, gram positive and gram negative bacteria (GNB) were 4.23% (n=26) and 92.19% (n=567) respectively with yeast recovered in only 3.58% (n=22) of the specimens. Among the isolates, Klebsiella pneumoniae 171 (30.15%) was the most common organism. The overall susceptibility of GNB was highest towards tigecycline (51.85%) followed by gentamicin (38.62%). Conclusion: Specific antibiotic utilisation strategies like antibiotic restriction, combination therapy may help to decrease or prevent the emergence of resistance. There is a need for further community based studies to identify the best treatment protocol for individual patients.

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