Background:The proportion of cases of extrapulmonary tuberculosis (EPTB) has increased in India in recent years. Since the disease can affect virtually all organs, has an atypical clinical presentation, the clinical samples for laboratory diagnosis are sometimes difficult to procure, the confirmation of diagnosis is often delayed. With this background, the present study was undertaken to identify the culture confirmed cases of EPTB from clinically suspected cases, to identify the patient related factors associated with the disease and common sites of involvement in these patients. Methods:The study comprised of 143 patients clinically suspected to have EPTB. Relevant clinical samples were collected from these patients according to the anatomical site involved. Confirmation of diagnosis was done by mycobacterial culture using Lowenstein Jensen (L-J) medium. Results: Out of 143 specimens, 42 (29.37%) were culture positive for mycobacteria (culture confirmed cases). Higher proportion of EPTB was found in females (36.92%) than males (23.08%). Maximum patients of EPTB belonged to the age group of 21-40 years (22 cases out of 57, 38.60%). Out of the 17 HIV positive patients, 6 (35.29%) were culture positive for mycobacteria. Maximum culture positivity was found with pus samples from bone and joint (44.12%) followed by lymph nodes (42.42%). Conclusion: It was found that female sex, younger age (below 40 years) and HIV infection were found to be commonly associated with extrapulmonary tuberculosis. While many studies report TB lymphadenitis as the most common form of EPTB, in our study bone and joint was found to be the commonest site involved in the disease followed by lymph node. Since EPTB has become more common than previously and is difficult to diagnose, it is important to have greater clinical suspicion for the disease and to take appropriate laboratory help for its confirmation.

Introduction: Tuberculosis, a disease of antiquity continues to cause high morbidity and mortality. In Sustainable Development Goals and End Tb Strategy proposed by WHO includes Drug Susceptibility Testing as major component. Conventional methods are time consuming and molecular methods are rapid but expensive and demanding. Resazurin assay is a rapid colorimetric redox indicator method of Drug Susceptibility Testing. Materials and Methods: 67 strains of M. tuberculosis isolated from pulmonary tuberculosis patients were tested using indirect absolute concentration method by resazurin assay and compared with drug incorporated Lowenstein-Jensen media for Isoniazid and Rifamycin. Results: There was 91.5 % and 91.7% concordance between both methods for INH and Rifamycin respectively. Resazurin assay for INH was 100% sensitive and 61.54% specific. Sensitivity and specificity for RMP was 98.04% and 62.5% respectively. The duration required for INH was 7.0 ± 2.07 and for RMP 6.58 ± 1.58 days. Conclusions: Resazurin assay is sensitive, rapid, cheap, technically simple drug susceptibility method.

Introduction: In Intensive Care Units (ICUs), Ventilator Associated Pneumonia (VAP) is the commonest nosocomial infection. Fungal infections especially Candida spp. have emerged as one of the commonest organisms in causing VAP. It increases morbidity and mortality to a great extent in critically ill patients, with risk factors like old age, co-morbidities like diabetes, Chronic Obstructive Pulmonary Disease (COPD), infectious or multisystem disease. Hence, it becomes necessary to isolate and speciate the fungi along with its Antifungal Susceptibility Testing (AFST) for early diagnosis and treatment. This is done by microbiological investigation where in samples (bronchoscopic/ nonbronchoscopic) are obtained from the lower respiratory tract. Aim: To study the fungal profile among clinically and radiologically diagnosed VAP cases. Materials and Methods: This was a prospective study carried out in the Department of Microbiology, Dr Vaishampayan Memorial Govt Medical College, Solapur, Maharashtra, India, in which 120 clinically and radiologically diagnosed VAP patients were included. Endotracheal Aspirate (ETA) of these patients was collected aseptically. The sample was then subjected to Gram stain, Lacto Phenol Cotton Blue (LPCB), culture on Sabouraud’s Dextrose Agar (SDA) and Chromogenic (CHROM) agar and AFST was performed by broth dilution technique. The data was statistically analysed. Results: In this study, out of 120 patients, 52 patients were diagnosed as VAP on day 5. Late onset pneumonia was more common in 61.67%. Non-infective cases were 49.17% and infective cases were 28.33%. Patients belonged to different age groups with maximum between 31-40 years. Out of 120 cases of VAP, yeast was isolated from 26 cases. Most common pathogenic yeast isolated was Candida albicans (53.85%). All yeast isolates were susceptible to fluconazole and amphotericin B except one isolate of Candida krusei, Candida tropicalis and Candida glabrata each were resistant to both fluconazole and amphotericin B. Conclusion: Candida albicans was the commonest yeast isolated. Resistance was noted among the non-albicans spp of Candida. The non-albicans Candida is growing as an emerging threat. Early diagnosis and AFST will help in reducing the morbidity and mortality.

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