PURPOSE: Multidrug-resistant organisms causing community-acquired and hospital-acquired infections are increasing at a dangerous rate. Carbapenemase-producing Enterobacteriaceae and Pseudomonas species are an important source of concern since these organisms are not only resistant to beta-lactam antibiotics but also show cross-resistance to other groups of antibiotics. In the present study, rapid detection of these carbapenemase-producing Enterobacteriaceae and Pseudomonas species by carbapenemase Nordmann–Poirel (Carba NP) test was evaluated by comparing with modified Hodge test (MHT). MATERIALS AND METHODS: Imipenem-resistant Enterobacteriaceae and Pseudomonas species isolated from various samples such as pus, blood, sputum, urine, and endotracheal aspirates were processed for carbapenemase detection by MHT and Carba NP test. Kappa analysis was done to evaluate the percentage agreement between the two tests. RESULTS: Seventy imipenem-resistant Enterobacteriaceae and Pseudomonas isolates were analyzed in the present study for carbapenemase production. 63.41% ofEnterobacteriaceae and 34.48% of Pseudomonas species were carbapenemase producers considering both the methods. By MHT, 36 (51.42%) isolates and, by Carba NP test, 35 (50%) isolates were positive for carbapenemase production out of the 70 isolates. CONCLUSION: Carba NP test when compared to MHT is a simple, rapid, cost-effective biochemical test which can be used in all laboratories in the identification of life-threatening carbapenemase-producing Gram-negative bacteria.

Background and Objectives: Acinetobacter baumannii has emerged as a major organism accounting for hospital acquired infections particularly in intensive care units. Due to production of different kinds of beta lactamases these bacteria have developed drug resistance rendering the treatment of such infections very difficult and expensive. Rapid identification of A. baumannii producing such beta-lactamases is the need of the hour in reducing morbidity and mortality associated with A. baumannii infections. Materials and Methods: A. baumannii was isolated from clinical samples like endotracheal aspirates, sputum, urine, exu- dates using standard culture techniques. Identification and drug sensitivity was done using Vitek 2 system. All the isolates were subjected to detection of ESBLs using phenotypic confirmatory test, plasmid mediated AmpC beta- lactamase by AmpC disc test, Carbapenemase production by CarbAcineto NP Test and Modified hodge method. Results: 149 A. baumannii isolates were analysed for antimicrobial susceptibility and various beta-lactamase production. Results were evaluated for statistical significance using Chi-Square and P value. 81.8% of isolates were from male patients with majority of them above 50 years of age. 88.5% of samples were from ventilator associated pneumonia patients. 83.8% of isolates were sensitive to tigecycline. Only 10% to 12% of isolates were sensitive to carbapenems. 23.4% of isolates were ESBL producers and 46.9% of them were AmpC producers. Modified Hodge test method identified 63.7% of A. baumannii as carbapenemase producers where as CarbAcineto NP test identified 63% and exibiting 94.74% sensitivity, 93.22% specificity when compared to Modified Hodge test. Conclusion: Multidrug resistant Acinetobacter spp. is on the rise. Present study showed that high percentage of drug resis- tance in A. baumannii could be due to production of ESBLs, AmpC and carbapenemases. Among all beta lactamases car- bapenemase producers are more and quickly raising in A. baumannii. Rapid, cost effective assay which can be adopted in all clinical laboratories is critical to prevent their further transmission particularly in hospital environment.

Early onset Ventilator associated pneumonia (VAP) is usually less severe, associated with a better prognosis, and is more likely caused by antibiotic-sensitive bacteria. Late-onset VAP, is usually caused by multidrug resistant (MDR) pathogens and is associated with increased morbidity and mortality. Therefore, the local microbial flora causing VAP needs to be studied and appropriate therapy based on the early endotracheal (ET) aspirate culture report can help managing this group of patients. The present study was carried out in the department of Microbiology, JSS Hospital, Mysore from January 2017 to December 2017. Bacterial pathogens and antibiotic resistance pattern of isolates from ET aspirates of patients on mechanical ventilation in Intensive care units were source of data. A total number of 1432 samples were received in the lab for ET aspirate culture. Among these 1432 samples, 1055 showed growth ranging from 10 2 to 10 6 colony forming units/ml (CFU/ml), 124 had no growth at all and 253 had no significant growth (<10 2 CFU/ml) Out of 1055 isolates,1023 were Gram negative bacteria and 32 were Gram positive cocci . Acinetobacter, Pseudomonas and Klebsiella were the major pathogens in our study. Majority of them being MDR, maximum sensitivity was observed for Tigecycline and colistin in these isolates. Knowledge of causative microbial flora of VAP along with information on the susceptibility patterns will help in selection of the appropriate antibiotic for therapeutic use for better outcome.

Dengue fever is one of the common viral illnesses linked with significant morbidity and mortality. Of late, there is rapid increase in dengue cases in India. The present study aimed to known dengue seropositivity in different seasons of a year, other laboratory parameters and its geographical distribution. During the study period of 15 months 4172 patients hospitalized with probable dengue fever were included. Dengue serology was done for all cases by ELISA(J. Mitra & Co). Demographic details were taken to create geographical maps of the disease. Of the 4172 suspected dengue cases, 817 had confirmed dengue illness. Of these 817 cases, 584 showed Ns1 antigen (71.4%), 150 IgM antibody (18.3%), and 38 had both Ns1 and Ig M (4.6%). Platelet count less than 1,00,000 were seen in 566 (69.27%) patients. Dengue was noticeably more during monsoon time (June to September) of a year. Through geographical maps major clusters were noticed urban areas of Mysuru and Krishnaraja Nagara , while few clusters were also observed in Periyapatna and T Narsipura taluks of Mysuru district. To minimize the load of dengue cases and its death rate better community awareness and vector control measures need to be strengthened during monsoon especially in areas where burden of the disease is more. This study helps in early preparedness of the authorities concerned in controlling possible epidemics in future.

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