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The emergence and global spread of carbapenem-resistant is of great concern to the health care facilities due to high rates of morbidity and mortality associated with them. It is necessary to know its epidemiology and the resistant pattern in a geographical area to formulate a antibiotic stewardship policy. To study the occurrence and mechanisms of carbapenem resistance in Escherichia coli.A total of 1172 clinical strains of obtained from various clinical specimens were screened for carbapenem resistance during the study period. Strains showing reduced susceptibility to imipenem &/or ertapenem &/or meropenem were included in the study. The resistance mechanisms were identified using various phenotypic methods. Total of 53/1172 were found to be carbapenem resistant (CRE). The most common sample in which CRE were isolated was urine (n=26, 49.1%). A total of 50 isolates were confirmed as Metallo-beta-lactamase (MBL) producers using Ezy MIC strip. One of the three non carbapenemase producing isolate was positive for ESBL with porin loss and the other two isolates were positive for AmpC with porin loss.MBL production being the most common mechanism of carbapenem resistance, the study indicates the importance of regular monitoring of drug resistance in the hospital for an urgent action to be taken for antibiotics stewardship in the institute.

BACKGROUND Staphylococcus aureus is a major pathogen causing a diversity of infections including bacteraemia, pneumonia, skin and soft tissue and osteoarticular infections. Infections due to MRSA are associated with increased morbidity and mortality in hospitalised patients. It also has the potential to cause sudden outbreaks in hospitals. Cost of treatment is another major problem found by patients in developing countries. Aims and Objectives-1. To differentiate MRSA into Hospital Acquired (HA) MRSA and Community Associated (CA) MRSA. 2. To know the antimicrobial susceptibility pattern of MRSA and Methicillin Sensitive Staphylococcus aureus (MSSA). MATERIALS AND METHODS This was a descriptive study. A total of 150 clinical isolates of Staphylococcus aureus from pus/ wound, blood, sputum, indwelling urinary catheter and urine during Nov 2011 to January 2013 were included. The S. aureus isolates were labelled as MRSA/ MSSA using cefoxitin (30 ug) discs and as hospital acquired and community acquired based on CDC criteria. RESULTS Out of 150 samples, 74 were MRSA and 76 were MSSA. Out of 74 MRSA samples, 51 were isolated from male and 23 were isolated from female. Out of 51 males, 41 were hospital acquired and 10 were community acquired. Out of 23 females, 21 were hospital acquired and 2 were community acquired. CONCLUSION Methicillin resistant S. aureus is a health risk in the community and to patients. HA-MRSA is an infection that can cause serious complications. This study emphasises the need for surveillance of patients who are admitted with HA-MRSA infection. This has important implication for MRSA epidemiology, infection control practices and empiric antimicrobial drug selection.