A study was conducted to determine the prevalence of opportunistic infections in HIV-seropositive patients at Kasturba Medical College Hospital, Mangalore. Three hundred and seven HIV-positive patients were screened for various opportunistic pathogens. Tuberculosis was the most common infection followed by candidiasis, cryptosporidiosis and cryptococcal meningitis.

Objective The present study has been undertaken to detect the presence of ESBLs producing Klebsiella species in various clinical specimens and their antibiotic susceptibility pattern. Materials and methods The study consists of 60 clinical isolates of Klebsiella species from various clinical specimens submitted to the microbiology laboratory, Kasturba Medical College Teaching Hospital Mangalore over a period of one year, between 1st January 2007 to 31st December, 2007. All isolates were identified morphologically and biochemically by standard procedures and ESBLs production was detected by re-arranging routine discs in a novel predictor disc approximation method. Antimicrobial susceptibility was performed using Kirby-Bauer disc-diffusion method where Imipenem disc, an inducer was placed in center and on either side of it at 15mm distance were placed ceftazidime and cefotaxime (indicator of induction). In addition, another inducer cefoxitin was placed 15mm from cefotaxime (indicator). This was placed opposite to that of ceftazidime + clavulanic acid to avoid any affect of inducible beta-lactamase on the zone of inhibition of the latter. Results A total of 16 out of 60 Klebsiella isolates (26.66%) were found to be ESBL producers. Conclusions Imipenem was found to be the most effective antibiotic (46.66%) followed by Cefoxitin (31.66%) and Cefotaxime (30.00%). Key words: Klebsiella species; clinical specimens; ESBLs DOI: 10.3126/jcmsn.v6i3.4070Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.19-23

Pseudomonas aeruginosa is a common opportunistic pathogen of humans among the Gram-negative bacilli. Clinically, it is associated with nosocomial infections like burns and surgical-site wound infections and remains a major health concern, especially among critically ill and immunocompromised patients. This is a prospective laboratory-based 2 year study conducted to isolate P. aeruginosa from wound specimens and the antimicrobial susceptibility pattern with reference to metallo-β-lactamase (MBL) production. Two hundred and twenty-four samples of P. aeruginosa isolated from wound specimens were included in the study. Antimicrobial susceptibility was done as per Clinical Laboratory Standard Institute (CLSI) guidelines. MBL-producing P. aeruginosa was detected using the EDTA disk diffusion synergy test. Statistical analysis was done using the SPSS 11 package (SPSS Inc., Chicago, IL). Out of the 224 P. aeruginosa isolates, 100% were susceptible to polymyxin B and colistin, 92·8% were sensitive to imipenem, 38% showed resistance to gentamicin followed by ceftazidime (31·69%) and meropenem (33·03). Sixteen (7·14%) isolates showed MBL production. Infection caused by drug-resistant P. aeruginosa is important to identify as it poses a therapeutic problem and is also a serious concern for infection control management. The acquired resistance genes can be horizontally transferred to other pathogens or commensals if aseptic procedures are not followed.

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Abstract:Background: Klebsiella species and Escherichia coli are members of the family Enterobacteriaceae encountered frequently as opportunistic pathogens in clinical settings. Cephalosporins are considered as first line drugs against Klebsiella species and Escherichia coli. Inappropriate use of β-lactams against gram negative bacteria has resulted in the widespread development of drug resistance. This study was done to know the prevalence of ESBL producing Klebsiella species and Escherichia coli among clinical isolates and to determine their antibiotic susceptibility patterns at Yenepoya Hospital, a tertiary care hospital. Materials and methods: A total of 200 isolates were obtained from clinical samples from April to June 2016. Samples were inoculated on MacConkey's and blood agar. The organisms were identified based on standard microbiological procedures. Routine susceptibility testing was performed by Kirby Bauer's disc diffusion method, as per the recommendations of CLSI. Following screening with Cefotaxime (30 μg) disc, resistance was then confirmed for ESBL production by phenotypic confirmatory disc diffusion test using Ceftazidime (30 ug) and Ceftazidime + Clavulanic acid (30 μg + 10ug) disc. Results: Out of 84 isolates of Escherichia coli and 116 isolates of Klebsiella species, 20(23.8%) and 26(22.4%) were ESBL producers respectively. These ESBL producers showed high degree of resistance to Ampicillin(100%) followed by Ceftazidime, Piperacillin and Cefotaxime for both Klebsiella species and E.coli. The most sensitive antibiotics were found to be Imipenem followed by Amikacin. Frequency distribution of ESBL producing E.coli and Klebsiella species was found to be highest among urine (42.5%) and sputum (25%)samples. Conclusion:The presence of ESBL producers has significant implications for patient management and indicates the need for regular and routine monitoring of ESBL producing clinical isolates in laboratory practices for proper disease management. .