Background: An alarming rise in the rates of the antibiotic resistance has now become a serious and an increasingly common public health concern, with severe implications, especially in the intensive care units. A variety of ß-lactamases which include ESBLs, AmpC ß-lactamases and metallo-ß-lactamases, have emerged as the most worrisome mechanism of resistance among the gram negative bacteria, which pose a therapeutic challenge to the health care settings. Materials and Methods:The present study was aimed at knowing the prevalence of various ß-lactamases in the gram negative isolates which were obtained from ICU patients. A total 273 gram negative isolates from 913 clinical samples which were received over a period of one year were processed for their identification and their antimicrobial susceptibility pattern was determined. They were then screened for the ß-lactamase production.Results: Among the 273 isolates, the ß-lactamase production was observed in 193 strains. 96 (35.16%) strains were ESBL producers, followed by 30 (10.98%) metallo ß-lactamase (MBL) producers and 15(5.4%) AmpC producers. The major ESBL and AmpC producer was Escherichia coli, while Klebsiella pneumonia was the predominant MBL producer. The co production of the ESBL/MBL/ AmpC ß-lactamases was observed in 52 (19.04%) strains and it was more common in Escherichia coli. A multidrug resistance to the fluoroquinolones and the aminoglycosides was also observed in the ß-lactamase producing organisms. Conclusion:The high prevalence of the ß-lactamases in the ICU isolates emphasizes the need for a continuous surveillance in the ICUs to detect the resistant strains, strict guidelines for the antibiotic therapy and the implementation of infection control measures to reduce the increasing burden of antibiotic resistance. INTRODUCTIONThe incidence of nosocomial infections in the intensive care units (ICU) is showing a rising trend, mainly because of the severe clinical conditions which are associated with the impaired immunity, increasing the use of invasive diagnostic procedures, lapses in the sterilization and the disinfection techniques and the indiscriminate use of antibiotics. The β-lactam antibiotics are among the most frequently prescribed antibiotics in the ICUs world-wide, which are favoured because of their efficacy, broad spectra and low toxicity. The selective pressures which are generated by the indiscriminate use of the beta-lactam antibiotics have led to the selection of a variety of mutated forms of β-lactamases such as the ESBLs, AmpC β-lactamases and metallo-β-lactamases which have emerged as the most worrisome resistance mechanism which poses a therapeutic challenge to the health care settings [1]. These "newer β-lactamases" are capable of hydrolyzing a wide range of β-lactam antibiotics, notably the extended-spectrum penicillins and the third and fourth generation cephalosporins, which include the carbapenams [2]. The ESBL producing organisms also express the AmpC β-lactamases and they may be co-transferred with the plasmids...

Background: To isolate the pathogenic bacteria and to know the antibiotic sensitivity in the community acquired neonatal sepsis. Methods: It was a prospective study undertaken on 300 neonates suspected of community acquired neonatal sepsis admitted in Pediatrics Department of Government Medical College,Amritsar over a period of one year from January2014 to December 2014.All these cases fulfilled the inclusion criteria required for the study.Blood culture of these cases was performed by Mackie and McCartney method and antibiotic sensitivity by Kirley-Baner's disc diffusion method. Results: 227 (79%) cases showed positive blood culture.Gram negative isolates (N=156;65.82%) were more frequent than gram positive isolates (N=81;34.18%). Most common isolate was KlebsiellaPneumoniae (N=77%;32.48%) followed by Staphylococcus Aureus (N=66;27.84%), E.Coli(N=37;15.66%), Pseudomonas Aeroginosa (N=28;11.81%), Acinetobacter (N=14;5.90%), Enterococcus(N=8;3.37%) and Coagulase Negative Staphylococcus Aureus (N=7;2.99%). Both gram negative as well as gram positive isolates showed high resistance to ampicillin and gentamycin. Gram negative isolates were highly sensitive to Polymixin B and Meropenem whereas gram positive isolates were highly sensitive to Linezolid and Vancomycin. Conclusion: Gram negative bacteria were more frequent causes of community acquired neonatal septicemia than gram positive isolates. Both gram positive and negative isolates showed poor sensitivity towards conventional first line antibiotics, rather were mainly susceptible to higher antibiotics. So the knowledge of the pattern of bacteriological isolates and their antimicrobial susceptibility pattern can be very helpful for prompt treatment of such patients, to decrease neonatal morbidity and mortality as well as reducing the emergence of multi-drug resistant organisms.

Our study generates data of HPV prevalence in patients with cervical lesions visiting tertiary care institute. The data generated will be useful for laying guidelines for mass screening of HPV detection, treatment, and prophylaxis.

Introduction: CMV disease ranges from asymptomatic infection in immunocompetent people to severe and lifethreatening infections in neonates and immunocompromised patients. The present study was undertaken to study the seroprevalence of CMV and use of Real-time PCR in detection and quantification of CMV in immunocompromised patients. Material and Methods: A total of 57 samples were tested for CMV IgM and CMV IgG by ELISA technique. The detection and quantification of CMV DNA was done by real time PCR. Results: Out of 57samples, 6 (10.53%) tested positive for CMV IgM, 50 (87.72%) were positive for CMV IgG and 18 (31.58%) were positive for CMV DNA by PCR. Among 18 PCR Positive cases, 6 (33.334%) cases showed viral load of 1x10 3 IU/ml. 4 (22.22%) cases each showed viral load of 1x10 4 IU/ml, 1x10 5 IU/ml, 1x10 6 IU/ml respectively. There is no statistical association of age, gender and geographical distribution with CMV IgM, CMV IgG and CMV DNA positivity. (P>0.05). Conclusion: This study demonstrated that Real-time PCR is more reliable test than serological ELISA test in the diagnosis of cytomegalovirus as Real-time PCR detects and quantifies viral DNA which is useful in predicting the patient's risk for disease and monitoring the effect of antiviral therapy. Good hygiene and infection control practices are advised to prevent CMV transmission.

Background Human papillomavirus (HPV) E6/E7 mRNA tests determine the oncogenic activity of the virus and represent a good clinical biomarker for predicting the risk of cervical cancer. So, the present study was conducted to know the role of HPV E6/E7 mRNA as a predictive biomarker for cervical carcinoma. Methodology The present study was conducted on 55 clinical samples of cervical scrapings and biopsy from the clinically suspected cases (based on signs and symptoms) of cervical cancer having abnormal PAP smear. The samples were processed in three steps—(1) HPV DNA detection, (2) HPV E6/E7 mRNA detection, and (3) histopathological analysis. Results Out of a total of 55 patients, 16 (29.09%) were positive for both HPV E6/E7 mRNA and HPV DNA and six were positive for only HPV DNA. So, a total of 22 (40%) patients were positive for HPV DNA. Out of these 22 samples, 10 (45.5%) were of HPV-16, six (27.3%) were of HPV-18, four (18.2%) were of HPV-31, and two (9.1%) were of HPV-45. Out of total 16 patients positive for HPV E6/E7 mRNA, 10 (62.5%) were of genotype 16 and six (37.5%) were of genotype 18. The patients who were found positive for HPV 31 and 45 genotypes did not have E6/E7 mRNA expression. On colposcopic-guided biopsy, among these 16 samples, eight (50%) were diagnosed with invasive squamous cell carcinoma, six (37.5%) with cervical intraepithelial neoplasia grade 3 (CIN3), and two (12.5%) with CIN2. Out of those six patients in whom only HPV DNA was positive, five had normal biopsy findings and one had CIN1. Conclusion The present study suggests that HPV E6/E7 mRNA detection could be more reliable than DNA testing for predicting the risk of progression of HPV-induced cervical lesions to cervical carcinoma and it can be used as a non-invasive tool for triage and patient follow-up.

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Introduction: Central venous catheter (CVC) related blood stream infections are associated with serious infectious complications resulting in significant morbidity, increased duration of hospitalization and added medical cost. Aim: The study was done to determine the incidence of central venous catheter related infections, their antimicrobial sensitivity pattern, biofilm production and associated risk factors in hospitalized patients. Material and Method: Catheter tip culture & blood cultures of 143 patients with indwelling central venous catheters were processed. Result: Out of 143 specimens, catheter tip colonization was observed in 45 samples, while 14 were both catheter tip as well as blood culture positive hence included ascatheter related blood stream infections (CRBSI). CRBSI was found significantly associated with increased duration of catheterization, increased number of attempts and placement of CVC in internal jugular vein. Most common isolated organisms were Klebsiella pneumoniae followed by Coagulase negative Staphylococcus, Staphylococcus aureus and Pseudomonas aerguinosa in CRBSI as well as in CVC colonization. Majority of them were resistant to Gentamicin, Ciprofloxacin, Ceftiazidime and Ceftrixone. Biofilm production was determined by tissue culture plate method and was found to be maximum seen in Klebsiella spp. Conclusion: Incidence of CRBSI was 9.79% and of CVC colonization was 34.26%. Rate of CRBSI was 8.53 per 1000 CVC days. Klebsiella pneumoniae was most common isolate and predominant biofilm producer and was found to be multidrug resistant to Gentamicin, Ciprofloxacin, Ceftiazidime.

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