AIM1. To analyse the clinically important Gram-negative isolates (Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa) and their susceptibility pattern in a tertiary care hospital; 2. To study the epidemiology of the isolates and sensitivity pattern of the Gram negative bacteria in a tertiary care hospital, Madurai, South Tamilnadu. METHODSSamples collected from different wards were subjected for culture, isolation and identification of Gram negative bacterial isolates and antibacterial susceptibility testing by Vitek System and Kirby Bauer method. This study was carried out in Apollo Speciality Hospital, Lab Services, Madurai. RESULTS6900 non-repetitive isolates from 29,275 patients were collected from urine, blood, pus and respiratory samples from January to December 2013-2015. The Gram Positive Cocci and Gram Negative bacterial isolates were 2357 and 4543, respectively. Urine (52%), blood (7%), respiratory samples (21%) and pus (20%) accounted for the samples from which these samples were obtained. Most common isolates in urine were E. coli (69%) and Klebsiella species (16%). Most common isolates in blood were E. coli (38%), Klebsiella species (25%) and Salmonella (13%). Most common isolates in respiratory samples were Klebsiella species (44%), Pseudomonas (28%) and E. coli (16%). Most common isolates in pus samples were E. coli (32%), Klebsiella species (23%) and Pseudomonas (27%). E. coli, Klebsiella species, Pseudomonas from urine, blood, respiratory samples, pus showed high sensitivity to Carbapenems, Piperacillin/Tazobactam, Cefoperazone/Sulbactam and Aminoglycosides. E. coli showed high sensitivity to Nitrofurantoin in urine. E. coli, Klebsiella species, Pseudomonas from urine, blood, respiratory samples and pus showed resistance to 3rd generation Cephalosporins, Fluoroquinolones and Trimeth/Sulfonamides. Overall, ESBL strains increased from 64% to 66.3% in 2014, then decreased to 63.7% in 2015, while Carbapenem resistant strains increased from 2.4% to 3.8%. CONCLUSIONIn this 3 years study we found that there was a progressive increase in antimicrobial resistance in isolates of E. coli, K. pneumoniae and P. aeruginosa, isolated from blood, urine, pus and respiratory culture specimens. ESBL production was seen in the majority of isolates of E. coli and K. pneumoniae. These bacteria showed high sensitivity to Carbapenem, Piperacillin, Tazobactam and Cefoperazone Sulbactam.

AIM1. To analyse clinically important Gram-Positive isolates (Staphylococcus aureus, Enterococcus Species and Streptococcal Species) and their susceptibility pattern in tertiary care Hospitals. 2. To study the epidemiology of the isolates and sensitivity pattern of Gram Positive isolates in South Tamilnadu. METHODSSamples collected from different wards were subjected to culture, isolation and identification of Gram Positive isolates and Antibacterial Susceptibility testing by Kirby Bauer method. This study was carried out in the Institute of Microbiology, Madurai Medical College, Madurai. RESULTS6900 non-repetitive isolates from 29,275 patients were collected. They were from urine, sputum, blood, pus and respiratory samples. Total number of Gram Positive isolates processed was 1022. Staphylococcus aureus was the most common organism isolated in our study followed by Enterococcus Species and Streptococcal Species. Staphylococcus aureus isolates showed high sensitivity to Glycopeptides, Clindamycin, Doxycycline, Cefazolin, Erythromycin and Amoxicillin-Clavulanic acid. This isolates showed low sensitivity to Penicillin, Trimethoprim/Sulphonamides and Ciprofloxacin. Enterococcus isolates showed high sensitivity to Glycopeptides. These isolates showed low sensitivity to Penicillin, Amoxicillin-Clavulanic acid, Ampicillin, Nitrofurantoin, Levofloxacillin, High Level Gentamicin and High Level Streptomycin. Streptococcus isolates showed high sensitivity to Penicillin, Clindamycin, Doxycycline, Erythromycin, Ofloxacillin and Ceftriaxone. Methicillin Resistant Staphylococcus aureus showed resistance from 5% to 4.20%. Vancomycin Resistant Enterococci showed resistance from 0.50% to 0%. CONCLUSIONIn this 3-year study, Staphylococcus aureus was the most common organism isolated from clinical specimens. Staphylococcus aureus isolates showed high sensitivity to Glycopeptides Clindamycin, Doxycycline, Cefazolin, Erythromycin and AmoxicillinClavulanic acid. Enterococcus isolates showed high sensitivity to Glycopeptides. Methicillin Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci exhibit lesser resistance rates in the 3-year study period. This study will help both clinicians and infection controlling practitioners to treat the patients. This single center study can give important information regarding emerging resistance patterns.

PURPOSE1. To find out the prevalence of Bacteroides fragilis in patients with Sepsis and to perform Antimicrobial susceptibility testing. 2. To identify the Metronidazole resistant Bacteroides fragilis and to confirm the resistant pattern genomically by gene sequencing. MATERIALS AND METHODSThis prospective study was conducted for 6 months in 175 patients with varied infections. The presumptive identification of Bacteroides fragilis was confirmed and Antimicrobial susceptibility testing was performed by Broth disc method described by Kurynski & Co-workers. Resistant strains confirmed by short sequencing by NCBI Blast. RESULTSBacteroides fragilis was isolated from 32 of 175 samples with a prevalence of 18.3%. Out of this 32 samples, only one organism revealed resistance to Metronidazole. CONCLUSIONThe prevalence of Bacteroides fragilis resistant to metronidazole was isolated in post-operative wound infections giving a warning signal to the clinicians on emerging Metronidazole resistance on nosocomial infections in this hospital.

PURPOSETo assess the prevalence of Streptococcal sore throat infections in the paediatric age group in order to provide prompt treatment at an early stage to reduce the fatal consequences of post-infectious sequelae.