Introduction: The presence of bacteria in the form of biofilms poses a problem in the fluid pathways of haemodialysis plants and procedures which are aimed to detach and neutralize biofilms are necessary to improve the patient safety and the quality of the healthcare.The present study was therefore aimed at isolating the organisms which colonized dialysis water systems as biofilms, as well as to study the effect of the sub inhibitory concentrations of chlorine on the biofilms which were produced by these isolates.Methods: Swabs were used to collect the biofilms which were produced on the internal surface of the dialysis tubing from the dialysis units. This study was conducted at the Department of Microbiology, Kasturba Medical College (KMC), Mangalore, India. The cultures were performed on MacConkey's agar and blood agar. The organisms which were isolated were identified and antibiotic sensitivity tests were performed. The biofilm production was done by the microtitre plate method of O'Toole and Kolter. The biofilm production was also studied in the presence of sub inhibitory concentrations of chlorine.Results: Acinetobacter spp and Pseudomonas aeruginosa were the two predominant organisms which colonized the dialysis water systems as biofilms. The sub inhibitory concentrations of chlorine did not bring about any decrease in the biofilm production by the isolates. On the contrary, there was an increase in the biofilm production. Conclusion:Our study highlighted the importance of using appropriate methods to improve the quality of the water in dialysis units. This in turn, may help in reducing the biofilm formation in the water systems of dialysis units and thus, contribute to the prevention of hospital acquired infections in the patients who need haemodialysis.

ObjectiveTo determine predictors of nutritive-sucking in babies < 34 weeks and estimate the appropriate preterm sucking readiness (PTSR) score as an indicator of readiness of nutritive-sucking.MethodsProspective longitudinal observational study conducted in Neonatal unit of a referral hospital attached to Medical College. Forty-nine inborn babies of 28-34 weeks’ gestation and on full gavage feeds were enrolled.Results(a) Nutritive-sucking was achieved at a median age of 14 days (Range 7–50). (b) Low birth weight (LBW) (< 1531.1 ± 142.8) and lesser gestational age (GA) (< 32.8 ± 1) were poor predictors (p < 0.05) and have a significant independent negative association (Correlation birth weight (BW) - 0.0222, GA − 2.2177) with age at which established nutritive-sucking was achieved. (c) PTSR score of ≥9 had the best prediction for achievement of nutritive-sucking at 14-days of life, with a sensitivity of 92.3% and specificity of 100%.ConclusionPTSR score is a sensitive and specific tool to predict the readiness for nutritive-sucking in preterm babies < 34 weeks.

TB remains a leading cause of morbidity and mortality in developing countries. The incidence of congenital TB is underestimated. Current recommendations regarding the management of neonates of mothers with tuberculosis are variable and no tangible guidelines have been advised. Congenital TB is fatal if untreated, moreover the mortality and morbidity is increased if the diagnosis and treatment is delayed. Therefore, the treating clinician should be aware of the unusual presentation of congenital TB. A high suspicion and good screening of mothers and neonates is of paramount importance. Congenital tuberculosis is diagnosed by Cantwell criteria. Isoniazid prophylaxis for 6 months is recommended in neonates born to mothers with TB who are infectious. Breastfeeding should be continued, and isolation is recommended only in certain circumstances such as mother is infectious, has multidrug resistant tuberculosis or non-adherent to treatment. BCG vaccine is recommended in all neonates however, the timing of administration varies according to various guidelines. Neonate diagnosed with congenital TB should be treated with anti-tubercular drug regimen.

BACKGROUND Female genital tract infections are polymicrobial in nature. Among the genital infections, bacterial vaginosis is the most common infection caused by anaerobic and microaerophilic organisms such as Bacteroides fragilis group, Mobiluncus species, Porphyromonas species, Prevotella group and Gardnerella vaginalis. Objective-Comparative evaluation of Nugent and Amsel criteria in diagnosis of various types of female genital tract infections. MATERIALS AND METHODS The present descriptive study was conducted in a tertiary care hospital in coastal Karnataka, South India during the period from July 2013 to June 2016. Of the 1217 women under study, 1054 cases were taken with complaints of vaginal discharge and 163 were included as control, which belongs to normal vaginal flora, confirmed by microscopy in the Dept. of Microbiology, Father Muller Medical College, Mangalore. High vaginal swabs from women of reproductive age group (15-45 years) and 163 age matched control group were examined by preliminary examination. RESULTS By employing Amsel and Nugent criteria, out of 1054 vaginal samples 415 (39.4%) were Normal vaginal flora, Vaginal Lactobacillosis 117 (9.3%), Bacterial vaginosis 315 (29.9%), Intermediate Bacterial vaginosis 11 (1.0%), Vulvovaginitis 6 (0.6%), Cervicitis 4 (0.4%), HIV 2 (0.2%), Candidiasis 106 (10.1%), Group B Streptococcus with Antenatal cases 73 (6.9%) and Trichomoniasis 5 (0.5%). No vaginal infections were detected from the control group. CONCLUSION BV, Candidiasis, Trichomoniasis and Vulvovaginitis are the most common conditions present among female genital tract infections. Nugent and Amsel criteria are the most cost effective and less time-consuming tests for the diagnosis of vaginal infections.

Background & objectives: Bacterial vaginosis (BV) involves the presence of a thick vaginal multispecies biofilm, where Gardnerella vaginalis is the predominant species. The reason for an increase in the number of G. vaginalis which are usually present as normal flora of the female genital tract in cases of BV, is not known. Hence, the objective of the present study was to compare the biotypes and virulence factors of G. vaginalis isolated from the genital tract of women with and without BV. Methods: High vaginal swabs collected from 811 women of reproductive age were cultured. G. vaginalis isolates were biotyped and tested for adherence to vaginal epithelial cells, biofilm formation, agglutination of human red blood cells (RBCs), protease production, phospholipase production and surface hydrophobicity. Results: Of the isolates from women with BV, 83.3 per cent (60/72) showed good adherence, 78.4 per cent (58/74) produced biofilm, 82.9 per cent (63/76) produced phospholipase, 67.1 per cent (51/76) produced protease, 77.3 per cent (58/75) were positive for surface hydrophobicity and 61.6 per cent (45/73) were positive for haemagglutination of human RBC. In case of G. vaginalis from non-BV women, 25 per cent (15/60) isolates showed good adherence, 18.4 per cent (9/49) biofilm production, 35 per cent (21/60) phospholipase, 36.6 per cent (22/60) protease, 41.7 per cent (25/60) surface hydrophobicity and 10.1 per cent (6/59) agglutination of human RBCs. Maximum number of isolates belonged to biotypes 6, 2 and 3. Biotype 3 was more associated with non-BV rather than BV; biotype 6, 2 and 1 were more associated with cases of BV. Maximum virulence factors were expressed by biotypes 6, 2 and 1. Interpretation & conclusions: Virulence factors were more expressed by G. vaginalis isolates obtained from women with BV rather than from non-BV. Biotypes 6, 2 and 1 were more associated with cases of BV and expressed maximum virulence factors.