Tuberculosis is the most important OI before initiation of HAART. Both EFV and NVP-based regimens are equally efficacious in controlling OIs.

MBL production was the main resistance mechanism in the 11 carbapenem resistant P. aeruginosa isolates collected, with multidrug resistance associating significantly with MBL production in P. aeruginosa from our institution.

Background: Diabetic foot infections are one of the most feared complications of diabetes. This study was undertaken to determine the common aetiological agents of diabetic foot infections and their in vitro antibiotic susceptibility. Methods: A prospective study was performed over a period of one year in a tertiary care hospital. The aerobic bacterial agents were isolated and their antibiotic susceptibility pattern was determined. Members of Enterobacteriaceae were tested for extended spectrum β-lactamase (ESBL) production by combination disc method and staphylococcal isolates were tested for susceptibility to oxacillin by screen agar method. Results: Klebsiella pneumoniae (20.5%), Pseudomonas aeruginosa (17%), Staphylococcus aureus (17%) and Escherichia coli (14.6%) were the most common aetiological agents. Polymicrobial infection was observed in 52% patients. The members of Enterobacteriaceae as well as Pseudomonas spp. and Acinetobacter spp. were found to be susceptible mainly to amikacin, piperacillin-tazobactam and imipenem. Staphylococcus aureus and Enterococcus spp. were susceptible mostly to vancomycin, with varying susceptibility to tetracycline. 56% of the isolates belonging to Enterobacteriaceae were producing ESBL and 65.5% of Staphylococcus aureus were methicillin-resistant. Conclusion: High prevalence of multi-drug resistant pathogens was observed. Amikacin, piperacillintazobactam, imipenem were active against gram-negative bacilli, while vancomycin was found to be active against gram-positive bacteria.

Background: Methicillin resistance in Staphylococcus aureus is associated with multidrug resistance, an aggressive course, increased mortality and morbidity in both community and health care facilities. Monitoring of newly emerging and prevalent Methicillin Resistant Staphylococcus aureus (MRSA) strains for their resistance patterns to conventional as well as novel drugs, are essential for infection control. Aims:To study the changing trends in resistance patterns of MRSA at our hospital. Settings and Design:This cross sectional study was carried out in a 750 bed tertiary care hospital in south India.

We studied the prevalence of ceftazidime resistance in Pseudomonas aeruginosa and the rates of extended-spectrum β-lactamase (ESBL), AmpC β-lactamase (AmpC) and metallo-β-lactamase (MBL) production among the ceftazidime resistant Pseudomonas aeruginosa. A very high rate of MBL production was observed, which suggested it to be an important contributing factor for ceftazidime resistance among Pseudomonas aeruginosa.

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The prevalence of CDI in our hospital was found to be 4%, which was relatively lower compared to other Indian studies. However, awareness of the risk factors may assist in identifying patients at higher risk for CDI, guide implementation of appropriate preventive measures, and modulate potential intervention measure during management.

Background:The high cost of CD4 count estimation in resource-limited settings is a major obstacle in initiating patients on highly active antiretroviral therapy (HAART). Thus, there is a need to evaluate other less expensive surrogate markers like total lymphocyte count (TLC) and absolute lymphocyte count (ALC).ObjectivesTo evaluate the correlation of TLC and ALC to CD4 count. To determine a range of TLC and ALC cut-offs for initiating HAART in HIV-infected patients in resource-limited settings.Materials and Methods:In a prospective observational cohort study of 108 ART-naive HIV-positive patients, Spearman correlation between ALC and CD4 cell count, and TLC and CD4 cell count were assessed. Sensitivity, specificity, positive and negative predictive values of various ALC and TLC cut-offs were computed for CD4 count <200 cells/cu.mm.Results:Good correlation was noted between ALC and CD4 (r=0.5604) and TLC and CD4 (r=0.3497). ALC of 1400 cells/cu.mm had a sensitivity of 71.08% and specificity of 78.26% for predicting CD4 cell counts less than 200 cells/cu.mm. Similarly, TLC of 1200 cells/cu.mm had a sensitivity of 63.41% and specificity of 69.57%.Conclusion:Either ALC or TLC may be helpful in deciding when to initiate antiretroviral therapy in resource-poor settings, though ALC is better than TLC as a surrogate for CD4 counts.