Candida auris is a recently described rare agent of fungemia. It is notable for its antifungal resistance. A total of 15 C. auris isolates, originating from seven cases of fungemia, three cases of diabetic gangrenous foot, and one case of bronchopneumonia from a tertiary care hospital in south India, were investigated. All of the 15 isolates were identified by sequencing and 14 of these along with 12 C. auris isolates previously reported from two hospitals in Delhi, north India, two each from Japan and Korea were genotyped by amplified fragment length polymorphism (AFLP). In vitro antifungal susceptibility testing (AFST) was done by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method. Candida auris isolates were misidentified as Candida haemulonii by VITEK. All were resistant to fluconazole [geometric mean minimum inhibitory concentration (MIC) 64 μg/ml] and 11 isolates were resistant to voriconazole (MIC ≥1 μg/ml). Forty-seven percent of the C. auris isolates were resistant to flucytosine (MIC ≥64 μg/ml) and 40% had high MIC (≥1 μg/ml) of caspofungin. Breakthrough fungemia developed in 28.6% of patients and therapeutic failure in 4 (66.7%) patients. Interestingly, the 26 Indian C. auris isolates from north and south India were clonal and phenotypically and genotypically distinct from Korean and Japanese isolates. The present study demonstrates that C. auris is a potential emerging pathogen that can cause a wide spectrum of human mycotic infections. The prevalence of a C. auris endemic clonal strain resistant to azoles and other antifungals in Indian hospitals with high rates of therapeutic failure in cases of fungemia is worrisome.

Fluconazole plus standard care was superior to standard care alone in accelerating wound reduction among patients with diabetes with deep-seated fungal infections in diabetic foot wounds. Those in the treatment group who did heal, healed more quickly (P ≤ 0.022), but overall healing was not different.

Introduction: ESKAPE pathogens include Enterococcus faecium, Staphylococcus aureus, Klebsiella pnuemonia, Acienetobacter baumanii, Pseudomonas aeruginosa and Enterobacter species. Currently all these organisms are the main cause of hospital infections globally and they have the property to effectively escape the effect of antibacterial drugs. Unstoppable success of these superbugs will lead to unwinnable war. The success of these pathogens is mainly because of the mutations, modifications of LPS. As the crisis for the antibiotic resistance continues to grow, the latest IDSA (infectious disease society of America) "Bad Bugs, No Drugs" reports the urge for new antibiotics in the research and development pipeline and proposes steps to tackle the shortage. Objective: The aim of the study was to characterize the antimicrobial resistance in ESKAPE pathogens isolated from 330 culture positive clinical sample. Method: Antibiotic resistance was determined by VITEK 2 and manual method was done on Kirby baurer method. MIC was determined by VITEK 2 and E-Test according to CLSI guidelines. Result: Out of the total cases 63 percent of the culture has ESKAPE pathogens. Except for S. aureus multidrug resistance index of ESKAPE pathogens revealed on increasing trend. Conclusion: ESKAPE pathogens are commonly identified in alarming frequency and knowledge of antimicrobial resistance will be aided for empirical treatment.