Background: The increasing frequency of MRSA infections and rapidly changing patterns in antimicrobial resistance, led to renewed interest in the usage of Macrolides-Lincosamide-Streptogramin B (MLSB) antibiotics to treat Staphylococcus aureus infection. Clindamycin is an important drug used in the treatment of MRSA and MSSA infection. The aim of this study was to determine inducible and constitutive clindamycin resistance among clinical isolates of Staphylococcus aureus by D-test.Methods: During a period of 6 months from July 2018 to December 2018, a total of 100 Staphylococcus aureus isolated from different clinical samples were subjected to routine antibiotic sensitivity testing by Kirby Bauer’s disc diffusion method. Methicillin-resistance was determined by using the cefoxitin (30 µg) disc. Incidence of MLSBc and MLSBi in Staphylococcus aureus isolates by D-test as per CLSI guidelines.Results: Out of 100 isolates of Staphylococcus aureus obtained from 350 clinical samples, 70(70%) were found to be MRSA and 30(30%) were MSSA. Among 100 Staphylococcus aureus isolates, 40% isolates showed MLSBi resistance, 28% isolates showed MLSBc resistance, 6% isolates showed MS phenotype and 26% isolates showed Sensitive phenotype. MLSBc and MLSBi were found to be higher in MRSA as compared to MSSA (21%, 27% and 7%, 10% respectively). All clinical isolates showed 100% sensitivity to Vancomycin and Linezolid in routine antibiotic susceptibility testing.Conclusions: Continuous surveillance of the MLSB resistance is important and required before the prescription of clindamycin to treat MRSA infections.

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BACKGROUND:Pesticides poisoning constitutes one of the most frequent poisoning in clinical practice all over the country and especially in this area where agriculture is the chief economic occupation. Acute organophosphorous poisoning ranks foremost in the list of agents which causes acute pesticide poisoning in the developing countries. Acute poisoning, accidental or due to deliberate ingestion or inhalation of these organophosphate chemicals is an important and one of the most common medical emergencies. Hence the present study is undertaken to evaluate demography and the clinical profile of organophosphorous poisoning cases admitted in Government General Hospital, Kakinada, Andhra Pradesh. AIMS & OBJECTIVES: Assessment of demography and the clinical profile of 50 patients with Organophosphorous poisoning. MATERIALS AND METHODS: In this descriptive study fifty patients with organophosphorous insecticide poisoning were evaluated by clinical examination. They were investigated and the results were analyzed. RESULTS: 1. The OP poisoning was most common in young adult males between the age group 16-30 years i.e 62% mostly belonging to rural area i.e 72%. 2. Oral route of exposure is the most common mode of poisoning i.e in 84% of cases often with suicidal intent. While accidental inhalational exposure and/ or skin contact is evident in 16% of cases only. 3. Chlorpyriphos and monocrotophos (together 66%) were the most commonly used pesticides of the organophosphorous group in the present study. 4. CNS manifestations (82% of cases) in the form of altered sensorium, muscular twitchings/ fasciculations were the most common presentation, apart from vomiting probably related to oral ingestion. Miosis is observed in 66% of cases only. 5.36% of patients presented with respiratory manifestations in the form of frothing, cough and pulmonary secretions while frank pulmonary edema was noticed in 22% of case.

Background: Harbouring of potential pathogens in operation theatres (OTs) and intensive care units (ICUs) of hospital is a major cause of patient’s morbidity and mortality. Environmental monitoring by the microbiological testing of surfaces and equipments is useful to detect changing trends of types and counts of microbial flora. High level of microbial contamination indicates the needs for periodic surveillance aimed at early detection of bacterial contamination levels and prevention of hospital acquired infections.Methods: During a period of 6 months from January 2019 to June 2019, Air sampling from Operation theaters and Intensive care units were done by settle plate method. Swabs were taken from different sites and equipments and bacterial species were isolated and identified from them.Results: A total of 1410 samples were collected from various sites of Operation theaters and Intensive care units over a period of 6 months in which 960 were surface samples and 450 were air samples. Out of 960 surface samples, 95(9.89%) and out of 450 air samples, 90 (20%) were bacterial positive. Isolated organism was divided into normal flora (CONS, Micrococci), contaminant (bacillus species) and pathogenic organism e.g. Staphylococcus aureus, Acinetobacter spp., Pseudomonas spp etc. Out of those 30 (16.20%) CONS, 50 (27.02%) Micrococci, 75 (40.50%) Bacillus spp, 16 (8.6%) Staphylococcus aureus, 1(0.54%) Acinetobacter spp, 2 (1.08%) Pseudomonas spp, 4 (2.16%) Klebsiella, 7 (3.78%) Escherichia coli were isolated.Conclusions: Strengthening surveillance and laboratory capacity will surely enhance infection prevention and control. Routine sampling is strongly recommended for increasing awareness to identify and control all possible sources and types of infections.

Friedlander (In 1883) isolated a capsulated bacillus from the lungs of patients who died of pneumonia (1). The microorganism was named after him as Friedlander's bacillus. Later on this organism was given the generic name of Klebsiella, and is reported worldwide (2). Klebsiella is a Gram negative, non motile, encapsulated, lactose fermenting facultative anaerobes belonging to the Enterobacteriaceae family (1,2). Seven species of Klebsiella -K. pneumoniae, K. oxytoca and K. granulomatis are associated with human illness; K. ozaenae