BackgroundThe emergence of resistant tuberculosis (TB) is a major setback to the global control of the disease as the treatment of such resistance is complex and expensive. Use of direct detection of mutations by molecular methods could facilitate rapid diagnosis of resistance to offset diagnostic delays. We evaluated the performance of the Genotype MTBDRsl (Hain Life Sciences) for the detection of second line resistant TB directly from stored smear positive sputum sediments.Methodology/Principal FindingsThe assay showed a diverse range of sensitivity and specificity, 91.26% [95% CI, 84–96] and 95.5% [95% CI, 87–99] for FQ (PPV ∼97% & NPV ∼ 87.67%), 56.19% [95%CI, 46–66] and 81% [95%CI, 66–91] for EMB (PPV ∼ 88.06% & NPV ∼ 43.21%) and 100% for SLD. Diagnostic accuracy for FQ, SLD and EMB was 94%, 100% and 63.51%, respectively. 1.17% (2/170) were heteroresistance strains, where the heteroresistance was linked to rrs gene. A varying rate of validity was observed 100% (170/170) for FQ, 94.11% (160/170) for EMB, 88.23% (150/170) for SLD.Conclusions/SignificanceGenotype MTBDRsl is simple, rapid, economical assay that can be used to detect commonly known resistance associated with Fluoroquinolone, second line injectable drugs and ethambutol. The assay detects the targeted resistance in less time as compared to phenotypic DST. But due to low NPV to FQ (88%) and EMB (43.21%), the assay results must be interpreted in coordination with the phenotypic DST.

INTRODUCTIONUrinary tract infections are a common health problem and are more common in women compared to men. 1 The altered physiological, anatomical and hormonal changes during Pregnancy makes the antenatal mother more prone for Urinary tract infection. Such infections can be either symptomatic or asymptomatic. The term asymptomatic bacteriuria (ASB) is used when a bacterial count of the same species over 10⁵/ ml in midstream clean catch specimen of urine is obtained on two occasions without symptoms of urinary tract infection.2 This is very ABSTRACTBackground: Asymptomatic bacteriuria (ASB) occurring in pregnant women can lead onto complications like acute pyelonephritis, hypertensive disease of pregnancy, premature delivery and intrauterine growth retardation if untreated. Methods:The present study aims to estimate the occurrence of asymptomatic bacteriuria in antenatal women and to study the antibiotic susceptibility pattern of the isolates. The Gram staining, pus cell count and culture was performed for 120 urine samples. Antibiotic susceptibility testing was done by Kirby Baeur disk diffusion method. MRSA (Methicillin resistant Staphylococcus aureus) and ESBL (Extended spectrum Beta Lactamases) producers were identified by Standard guidelines. The sensitivity, specificity, negative predictive values and positive predictive values of Gram staining and pus cell count was calculated. Results: Out of the 120 samples 14 (11.66%) were positive for asymptomatic bacteriuria. The Gram staining showed specificity and negative predictive value of 95.2% and 98.1% respectively. Pus cell count showed a specificity and negative predictive value of 96.29% and 98.11% respectively. Escherichia coli were the predominant species isolated 5 (35.7%). Among the gram negative bacteria, amikacin and nitrofurantoin showed a susceptibility of 90% and 80% each. All the staphylococcus aureus isolates showed 100% sensitivity for nitrofurantoin. Two Klebsiella spp and one Escherichia coli isolate were identified as ESBL producers. Among the S. aureus isolates 3 were identified as Methicillin resistant (MRSA). Conclusions: Urine culture should be performed for all pregnant women irrespective of the symptoms and should be treated promptly to prevent the complications arising out of ASB.

The ability of Staphylococcus aureus to form biofilms is of significant clinical interest, as biofilm development impacts the efficacy of antimicrobial therapy and the subsequent outcome of an infection. The present study is undertaken to detect the biofilm production and to determine the antibiotic susceptibility pattern among the Staphylococcus aureus isolates. A total of 100 Staphylococcus aureus isolated for the first time from pus, blood, catheter, IV cannulas were included in the study. Biofilm detection was done by tube method and Microtitre plate method. Antibiotic susceptibility was done by Kirby bauer disc diffusion method. Methicillin resistance was detected by Cefoxitin disc diffusion method. By tube method and Microtitre plate method 26% and 46% of the isolates were identified as biofilm producers. By Microtitre plate method, BHI broth (Brain heart infusion broth) and BHI broth with sucrose was used and the difference in the biofilm forming ability was compared. When BHI broth with sucrose was used 69% showed biofilm formation whereas when tested with BHI broth, only 46% were identified as biofilm producers. Good sensitivity was observed for Amikacin (88%) and cefotaxime (82%). MRSA (Methicillin resistant Staphylococcus aureus) was detected among 19% of the isolates. Among the biofilm producers if there are drug resistant bacteria like MRSA the problem becomes challenging and requires combination of several antibiotics. Hence Screening for biofilm production by bacterial isolates should be performed. Infection control program should address the effective execution of disinfection procedures.

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Background:The β lactamase enzymes produced by the organisms break down the structural beta-lactam ring of β lactam antibiotics. Many genera of gram negative bacteria possess a naturally occurring, chromosomally mediated β lactamase and also some are plasmid mediated β lactamases. The objective of the study was to detect extended spectrum β lactamases among gram negative clinical isolates. Methods: 200 clinical were subjected to routine disc diffusion technique and zone diameter of ≤27mm for Cefotaxime and ≤22mm for Ceftazidime or ≤25mm for Ceftriaxone were included in this study. The strains are subjected to double disc synergy test. Conclusions:In the present study prevalence of ESBL was 23.3%, the high prevalence may be due to irrational use of third generation cephalosporins in both the hospital and community.