PurposeTo investigate the antimicrobial sensitivity pattern of commonly prescribed antimicrobials (chloramphenicol, cefixime, ofloxacin, azithromycin, and ceftriaxone) against Salmonella enterica isolates.MethodsBlood culture positive isolates of S. typhi and S. paratyphi A (N = 251) received at Metropolis Healthcare Limited (Mumbai, India) from four zones of India (North, South, West, and East) between April and August 2018 were tested for antimicrobial susceptibility by E-test method. Based on the minimum inhibitory concentration (MIC), the organism was categorized as sensitive, intermediate, and resistant against the respective antibiotics as per Clinical and Laboratory Standards Institute criteria 2018.ResultsOut of 251 Salmonella isolates, 192 (76.5%) were S. typhi and 59 (23.5%) were S. paratyphi A. All 251 (100%) Salmonella isolates were sensitive to cefixime, ceftriaxone, and azithromycin; 237/251 (94.4%) isolates to chloramphenicol and only 9/251 (3.6%) isolates were sensitive to ofloxacin. Based on average MIC and MIC breakpoints, Salmonella isolates were found to be sensitive to chloramphenicol (MIC: 3.89±6.94 µg/mL), cefixime (MIC: 0.13±0.11 µg/mL), azithromycin (MIC: 3.32±2.19 µg/mL), and ceftriaxone (MIC: 0.11±0.18 µg/mL) and resistant to ofloxacin (MIC: 2.95±6.06 µg/mL). More than 20% of Salmonella isolates had MICs of chloramphenicol as 1.5 µg/mL (27.85% isolates) and 2 µg/mL (29.53% isolates).ConclusionOur study confirms the re‑emergence of susceptibility of Salmonella isolates to chloramphenicol. Further, the concern about fluoroquinolone-decreased susceptibility as indicated by the intermediate susceptibility or resistance was reiterated in this study. Though cefixime, azithromycin, and ceftriaxone showed susceptibility, the possibility of antibiotic resistance with the irrational use of these antibiotics cannot be deterred. This study thus emphasizes the need for continuous evaluation and judicious use of antimicrobials, considering the ever-changing landscape.

Background: Acinetobacter species have emerged as important cause of nosocomial infections like pneumonia and urinary tract infections. Acinetobacter species are known to be highly resistant to commonly used antimicrobial agents. SinceAcinetobacter species are ubiquitous and have tremendous colonizing capacity, it is difficult to explain the role of Acinetobacter acquisition in the ICU and medical wards. The objective of this study was to determine the frequency of urinary tract infection (UTI) caused by different Acinetobacter species in hospitalized patients and in the community and to analyze their antimicrobial susceptibility pattern. Materials and Methods: This is a retrospective analysisfrom January 2016 to December 2017. Urine samples collected in appropriate sterile manner were screened for polymorphonuclear leucocytes and bacteria by routine microscopic examination. This was followed by plating on MacConkey's agar and Blood agar. Isolated Acinetobacter strains which are oxidase negative and non-lactose fermenters from MacConkey's agar were identified with Matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) to confirm the TM identification. Antibiotic susceptibility was performed by VitekCompact™ 2 (Biomeuriux, France) as per CLSI standards establishing MIC (Minimum Inhibitory Concentration). Results: Of the 429 isolates of Acinetobacterspecies from urinary tract, Acinetobacterbaumannii complex (78%) found to be the most common species followed by Acinetobacterjunii(10%) and Acinetobacterbaumannii(8%). Of the 334 (78%) isolates of Acinetobacterbaumannii complex from urinary tract, 73 (21.85%) isolates were resistant with doripenem, 62 (18.56%) with imipenem and 59 (17.66%) were resistant with meropenem with MIC values >=8 μg/ml. The rest of the isolates like Acinetobacterjunii, Acinetobacterjohnsonii, andAcinetobacterlwoffiiare found to be more sensitive with carbapenems with lower MIC values. Discussion: The treatment of multidrug-resistant bacteria in hospitalized patients continues to be a challenge for the clinician's in routine practice. Acinetobacter baumannii complex has proven to be an important pathogen in health care associated infections with significant mortality and morbidity. The drug resistant nature of the pathogen and its unpredictable susceptibility patterns make empirical and therapeutic decisions even more difficult. Conclusion: A. baumanniiis an important opportunistic agent of nosocomial UTI, especially in patients with longer hospitalization, antibiotic exposure, urinary catheterization and decreased immunity. High antimicrobial resistance and patient co-morbidities limit therapeutic choices. Hence, alternative therapeutic options are urgently needed to treat a patient with A. baumanniiinfection.

CMV infection is common in all populations but rarely associated with symptomatic illness in immunocompetent individuals. Immunocompromised patients are more commonly affected and it is a major cause of multi-organ dysfunction. The severity of disease depends upon degree of immunosuppression. Infection with CMV is extremely common but disease is a rare occurrence. The large majority of infections are clinically in apparent as with other Herpes virus infections, leading to prolonged latency, with occasional reactivation. Intrauterine or postnatal infections may lead to the development of clinical disease. Cytomegalic inclusion disease is seen almost exclusively in infants born to mothers developing primary CMV infection during pregnancy. Cytomegalic inclusion disease of the newborn or fetal death are common sequelae of Intrauterine CMV infections. This is associated with hepatosplenomegaly, jaundice, thrombocytopenic purpura and hemolytic anemia. The cytomegalic inclusion disease is probably the most important cause of microcephaly. Other manifestations are chorioretinitis and cerebral calcification. Survivors may show mental retardation. The diagnosis of CMV relies on demonstration of the agent (virus, viral proteins and nucleic acids) either in body fluids, and/or tissue or on serological responses in a patient with clinical findings consistent with CMV infection. Antivirals for systemic treatment of congenital and perinatal CMV infection are ganciclovir and valganciclovir. High-risk group such as patients undergoing allogenic bone marrow organ transplantation, acquired or innate immunodeficiency syndromes and premature infants are ideal candidates for prophylaxis against CMV infection. Administration of CMV immunoglobulins and screening of blood and organ donors for virus and its products are considered in prevention.