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It is necessary to determine the susceptibility pattern of clinical isolates especially nosocomial one in the clinical settings for making strategy for effective empirical treatment & to reduce incidence of multidrug resistant bugs. Aim of this study was to detect the antimicrobial susceptibility pattern of P. aeruginosa isolates from clinical samples between

Introduction: Multi-drug resistant tuberculosis (MDR-TB) that is the tuberculosis that is resistant to at least 2 of the first line anti-tuberculosis drugs is fatal infectious disease. Cases of MDR-TB are now increasing with 30,000 cases of MDR-TB reported in 2013 by national TB programme. Rapid diagnosis of MDR-TB is extremely important for rapid treatment of patient and to prevent spread of MDR-TB to other. BACTEC 960 system helps in rapid diagnosis but purchase of expensive instrument for the same is the limitation. However, the same purpose can be solved by use of semi-automated MGIT system. Aims and Objectives: Aim of this study is to do drug sensitivity testing of the first line anti-tuberculosis drugs with the use of semiautomated MGIT systems. 350 newly registered and suspected cases of tuberculosis in tertiary care hospital were included. Samples were processed for digestion and decontamination and inoculated in MGIT tubes and also on LJ medium. Reading was taken using semi-automated MGIT system. Positive tubes were confirmed by rapid test for M. tuberculosis and then drug sensitivity was performed. Result: Out of 350 samples, 62% were sputum; 33% were pleural fluid and rest 5% were lymph node, Ascetic fluid, CSF, pus. Average day of positivity by MGIT was 13 -20 days as compared to 25 -37 days by solid medium, which was statistically significant with p value < 0.01. MDR cases were 2% out of 350 samples. Conclusion: Manual MGIT System is a simple, efficient, safe to use diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for detection of fluorescence. The rapidity by which mycobacteria are detected is the most important advantage of the Manual MGIT. In areas with limited resources where purchase of expensive instruments such as the MGIT960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be a possibility.How to cite this paper: Mistry, Y., Rajdev, S. and Mullan, S. (2016) Use of Cost Effective Semi-Automated (Mannual/Micro) MGIT System over BACTEC 960 to Perform First

Background: Tuberculosis is a highly infectious disease and India has the highest burden with it. Diagnosis of tuberculosis in many countries is still dependent on microscopy. Although its sensitivity is low in comparison to culture and molecular methods, its sensitivity can still be improved by using fluorescence staining method and processing of samples by homogenization and concentration method. Material and methods: Samples were collected from all newly registered suspected cases of tuberculosis in tertiary care hospital from outward and indoor department during a period of one year. Smears were prepared for Ziehl Neelsen stain and fluorescence stain both before and after homogenization and concentration procedure by 4% NAOH-2.9% sodium citrate method and results of them were interpreted according to RNTCP criteria for grading of sputum samples. All the samples were cultured in liquid culture MGIT system (Mycobacterial Growth Indicator Tube) and results of microscopy were compared with liquid culture taken as gold standard. Data were analyzed by using SPSS software version 16. Result: 350 samples were collected during study period. Out of 350 samples, 48 samples were positive for M. tuberculosis by MGIT system. In comparison with MGIT system, sensitivity of Z N stain for detection of acid fast bacilli was 77% before decontamination procedure, which was increased up to 85.42% after decontamination and concentration process. Sensitivity of fluroscence stain was 85.42% before processing, which was increased up to 91.67% after processing of samples. Conclusion: Sensitivity of smear microscopy can be enhanced by use of fluroscence microscopy and concentration method.

Background: Efficient tuberculosis (TB) control is based on an early diagnosis followed by the rapid identification of drug resistance, in order to treat patients adequately, break the chain of transmission, and avoid the spread of resistant strains. Multidrug-resistant (MDR) Mycobacterium tuberculosis have emerged worldwide and seriously threaten TB control and prevention programs. At the same time, the emergence of extensively drug-resistant tuberculosis (XDR TB) has also become an important global health problem. Objectives: To detect common gene mutation pattern associated with drug resistance against second line anti-tuberculosis drugs in TB patients by SL-LPA as a rapid and early diagnostic test. Materials and Methods:total 652 sputum samples were received from 30 districts at culture district laboratory, Jamnagar from October 2018 to December 2018, and were included in the study. Second line Second line- line probe assay (SL-LPA) was used to detect mutations associated with resistance for anti-tuberculosis drugs. Results: Out of the 652 samples analyzed for mutations associated with second line anti-tuberculosisdrug resistance, 43% of the samples exhibited various forms of mutations. Out of these samples, mutations associated with gyrA gene were detected in 36.6% samples, gyrB gene mutation in 0.7% samples, rrs gene mutation in 4.4% samples and eis gene mutation in 1.2% samples. Conclusion: The present study provide information on the mutation pattern of drug resistant strains present in the geographical area and help to provide the basis for effective strategies for control of drug resistant TB in this region. It also re-emphasizes the importance of second line LPA which can diagnose TB and drug resistance in a single day and allows earlier administration of appropriate treatment as compared to culture result which take 1-2 months.

Haemophilus species are Gram-negative coccobacilli that require factor X and factor V for growth. Beyond this, it is a finicky bacterium to culture, and any modification of culture procedures greatly reduces isolation rates. Poor quality of laboratories in developing countries results in its poor isolation rates. This study was done with the objective of finding out the optimal cultural environment and media so that it could be maintained for a longer period in economical settings like ours which was done using H. influenzae ATCC 49,766. In this study, several culture media were tested as a means to preserve H. influenzae ATCC like TSB + glycerol + sheep blood, BHI broth, BHI broth + glycerol, BHI broth+ glycerol + sheep blood, Chocolate agar slant and satellitism plate. Three sets of respective media were inoculated with 18 -24 hours growth of H. influenzae. They were incubated at 37˚C 48 hours in a candle extinction jar. The media were checked for growth by subculturing them on chocolate agar plates and identified by biochemical reactions. Each set was maintained at 2˚C -8˚C, −20˚C and at room temperature and checked for the viability 24 hourly by subculturing them on chocolate agar. Results showed best growth of H. influenza on chocolate agar slants for 15 -20 days, followed by BHI + glycerol + sheep blood broth and satellitism plate for 4 -6 days followed by BHI broth for 2 -4 days. There was no growth in TSB + glycerol + sheep blood broth and BHI + glycerol broth media. Present study showed similar results as done by NS Srikanth et al. 2003 with growth on chocolate agar & satellitism plate for 3 -5 days but no growth in TSB + Glycerol + Sheep blood broth media. Chocolate agar slant is by far the most long term preserving media for H. influenzae. However, growth on BHI broth with various modifications is also showed a good preservation for 3 -5 days, so with further experiments we can hope to maintain the organism in these media also.

Introduction: The recent COVID-19 pandemic has prompted concern about the compatibility of IPC guidelines with health care workers, their working practices and behaviours. These guidelines can be difficult and time-consuming to adhere to in practice. By identifying barriers and facilitators to IPC guideline adherence, especially using personal protective equipment (PPE), we can identify focussed strategies that will support health care workers to undertake the IPC measures needed at such a critical time in health care internationally. Material & Methods: This was a cross-sectional study designed during the COVID-19 pandemic management in the South Gujarat region, to analyse the knowledge, attitude and practices of health care workers about their usage of personal protective equipment. A semi-structured questionnaire-based study was prepared, deriving pointers from our previous experience of seasonal flu outbreaks. 225 participants enrolled who were doctors, resident doctors, nurses, lab technicians, ward boys and food distributors. Result: Analysis of the barriers-related questions show good preparedness by the medical institution. Overall we found good knowledge, attitude and practice related to PPE during COVID-19 pandemic management. There are few gaps found in the knowledge of donning of PPE (p-0.0075), N-95 mask related knowledge (p-0.01) and the attitude that PPE use causes discomfort while nursing patients (0.0001).

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