Background and Aims Emergence of multi drug resistant MDR gram negative bacteria GNB is a serious threat and major challenge encountered by healthcare professionals. This study aimed to evaluate the distribution of antimicrobial resistance patterns in drug resistant GNB isolated at tertiary care hospital.Methods A total of 934 GNB strains were included in this study. Bacterial identification and disk diffusion testing were performed using standard microbiological techniques. Phenotypic detection of ESBL was assessed using double disk synergy test. Multiplex PCR assay was optimized to detect NDM-1 OXA-48 VIM IMP and KPC genes in carbapenem resistant GNB.Results The most common GNB identified were E. coli n46449.7 K. pneumoniae n13714.7 Acinetobacter Sp n13114 P. aeruginosa n11212 and Enterobacter Sp n313.3. Out of 934 isolates 808.6 were resistant to all tested antibiotics including carbapenems fluoroquinolones and aminoglycosides with high rate of resistant among Acinetobacter sp n454.8. On the other hand among 16818 carbapenem resistant isolates NDM-1 was most predominant in E. coli n2313.7 followed by K. pneumoniae n169.5 Acinetobacter Sp. n158.9 and P. aeruginosa n84.8. OXA-48 was most common in Acinetobacter Sp. n4124.4 followed by E. coli n74.2 and K. pneumoniae n63.6. Among 221 23.7 ESBL producing GNB E. coli n16717.9 was most common followed by K. pneumoniae n303.2 and Acinetobacter Sp n91.Conclusions The occurrence of bacterial infections caused by MDR-GNB and carbapenem resistant GNB infections is high. It is important for clinicians to evaluate and focus on the risk factors associated with the acquisition of MDR and carbapenem resistant organisms in hospital environment.
The present study was undertaken to screen for carbapenem resistance and the ability of efflux pump inhibitors to inhibit this resistance in enterobacteriaceae strains isolated from clinical specimens from patients attending Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER) hospital and water samples in and around Puducherry. A total of 425 carbapenem resistant isolates from clinical samples were studied by both phenotypic and genotypic methods. Two hundred and forty eight (248) strains were positive for metallo beta lactamase in the double disk synergy test (DDST) and 264 strains were positive for modified Hodge test (MHT). Multiplex PCR assays revealed that 262 of the 425 strains harboured blaNDM-1 gene. Efflux pump inhibitory activity of Phenylalanine arginine betanaphthylamide (PAβN) was detected for these strains. This study demonstrates that, 30 strains out of 163 blaNDM-1 negative strains were found to exhibit efflux pump activity. This study brings out the fact that such carbapenem resistant strains are limited only to clinical samples and not found in water samples in and around Puducherry.
Leptospirosis is a serious public health concern worldwide. It is highly endemic in the Andaman Islands and its prevalence is increasing in other Indian states. Clinical features are non-specific and diagnosis relies on laboratory confirmation. The gold standard is microscopic agglutination testing, but this is not widely available. Real-time polymerase chain reaction testing of LipL32 antigen provides the earliest detection of pathogenic Leptospira in the body. We found it to be 100% specific, but it should be used in the first 10 days of illness for reliable results.
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