Background:Acinetobacter is clinically important pathogen with widespread resistance to various antibiotics. We assessed the incidence of Acinetobacter infection at a tertiary care hospital, analyze their resistance pattern and identify the production of extended spectrum β-lactamases (ESBLs) and metallo β-lactamases (MBLs).Materials and Methods:The study was conducted in tertiary care hospital, India over a period of 2 years. Acinetobacter species were isolated from various clinical samples received in Department of Microbiology. After identification, Acinetobacter isolates were speciated and antibiotic susceptibility was determined by the standard disc diffusion method. ESBL and MBL production was detected by the double disc synergy test and combined disc diffusion test respectively.Results:Of 3298 infected samples, 111 (3.36%) were found to be Acinetobacter. The most predominant species was Acinetobacter calcoaceticus-A. baumannii (Acb) complex (72%). High incidence of resistance was recorded for piperacillin (55%), followed by ceftriaxone (46%) and ceftazidime (46%). Isolation rate and antibiotic resistance was higher in the Intensive Care Units (ICUs) of the hospital. ESBL and MBL production was detected in 31.5% and 14.4% of the isolates respectively.Discussion and Conclusion:A high level of antibiotic resistance was observed in our study and maximum isolation rate of Acinetobacter was in the ICUs. Acb complex was the most predominant and most resistant species. The analysis of susceptibility pattern will be useful in understanding the epidemiology of this organism in our hospital setup, which will help in treating individual cases and controlling the spread of resistant isolates to other individuals.

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Introduction-Pantoea agglomerans (P. agglomerans)is gram negative bacterium that belongs to the family Enterobacteriaceae. It is an opportunistic pathogen in the immunocompromised, causing wound infections, bacteremia, and urinary tract infections. This species is currently listed as a Biosafety level 2 (BL2) organism due to clinical reports as an opportunistic human pathogen. Septic arthritis or synovitis is usually common, clinical manifestations caused by P. agglomerans and often correlated with a predisposing factor i.e. immunodeficiency (diabetes mellitus, malignancies, extremes of age) or use of central catheter. This is first described case of septic arthritis following a road side injury. Case Report-In May 2012, A 40 year old male was admitted to the hospital with pain in left leg since last three months and swelling in his left knee for 4 days which was insidious in onset. On physical examination he was a febrile. His left knee was warm, swollen and tender. Three days later he became febrile and swelling gradually progressed resulting in cellulites. Ampicillin and Gentamicin were initiated/ started empirically. Later on an ill defined ulcer with irregular margin developed associated with purulent discharge. Patient was diagnosed as septic arthritis. Arthrocentesis was done and aspiration of synovial fluid was sent for culture and sensitivity to microbiology department and culture growth was phenotypically identified as P. agglomerans. The final identification of the bacteria by the Vitec 2 Systems (bioMerieux, France) was P. agglomerans. with multidrug resistant pattern in in-vitro testing .

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