Microbiological infection plays vital role in determining the outcome as well as cost and duration of the hospital stay for patients admitted in ICU setup. Of late nosocomial infections especially ventilator associated pneumonias (VAP) have been recognized to be associated with significant morbidity and mortality in intubated patients. It is of critical importance to do regular surveillance of important pathogen (like Methicillin resistant staphylococcus aureus (MRSA), extended spectrum beta lactamase (ESBL) and carbapenemase producers) and its resistance pattern. Culture and sensitivity patterns if properly determined can greatly improve the outcome of critically ill patients being managed in intensive care units. To find out the prevalence of MRSA, ESBL and carbapenemase producing isolates in endotracheal and tracheostomy tube samples of ICU patients and to know its resistance pattern. In this study we aimed to investigate the pattern of microorganism grown and their sensitivity patterns to propose a proper antibiotic treatment in our hospital ICUs. It was a cross sectional observational study which was carried out over a period of 6 months in the department of microbiology at a tertiary care hospital. Approval of ethical committee was obtained before the study. Total 70 samples consisting of endotracheal tubes and tracheostomy tube secretions received in the department of microbiology for culture and sensitivity from patients admitted in two ICUs (SICU, MICU) were processed as per standard microbiological protocol. Pathogens were identified by vitek 2 compact system. MRSA, ESBL and carbapenemase production was detected by vitek 2 system (Biomerieux) antibioticsusceptibility testing of MRSA, ESBL and carbapenemase producers was done. Antibiotics for testing were chosen as per vitek Id cards. The sensitivity patterns of MRSA, ESBL and carbapenamase producers were analyzed. Out of 70 samples 48(68.57%) were culture positive in which 41(87.27%) were monomicrobial and 7 (12.72%) were polymicrobial (2 organisms in 7 samples). Out of 55 isolated organisms 8 were gram positive cocci (14.54%) and Gram negative organisms were 47 (85.46%). Thus total 9 types of organisms were recovered from 48 culture positive samples. Forteen Pseudomonas aeruginosa (25.54%), 14 Acinetobacter baumanni complex (25.54%), 11 Klebsiella pneumoniae. (20%) and 8 Staphylococci (including Staphylocococcus aureus 03 and 05 coagulase negative Staphylococcus (CONS) (14.54%). Followed by 3 E. coli (5.45%), 2 Enterobacter aerogens (3.64%), 1 species each of Serratia marscens, Stenotrophomonas (1.82%). Out of 8 Staphylococcus (S. aureus and CONS) isolates 5 (62.5%) were MRSA and MRCONS. Most of the MRSA isolates were recovered from the endotracheal tube. Out of all isolates of Klebsiella species and E. coli 8 species were ESBL producers (57.14%). The maximum ESBL producing isolates were recovered from MICU and were isolated from endotracheal tubes. Isolated MRSA strains were found to be susceptible to vancomycin, linezolid, teicoplanin and rifampicin...

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Introduction: In the Revised National Tuberculosis Control Program (RNTCP), microscopic examination of sputum for acid-fast bacilli (AFB) is currently the backbone for the diagnosis of pulmonary tuberculosis. Studies have shown liquefaction and concentration of sputum by 5% sodium hypochlorite is useful in providing increased sensitivity and safety for the handling of specimens. Objective: To assess the utility of the 5% Sodium hypochlorite concentration method in increasing the sensitivity of smear microscopy for detection of AFB for diagnosis of pulmonary tuberculosis. Methods: The study included a total of 1000 sputum samples from 500 patients with suspected pulmonary tuberculosis. Direct smears were prepared from the sputum samples as per RNTCP guidelines. The remaining sputum was used for bleach concentration and smears prepared from the concentrated material. Both smears were stained by Ziehl-Neelsen staining and screened for acid-fast bacilli and graded according to the RNTCP guidelines. Results: A total of 158 samples (15.8%) from 89 patients were positive by a routine direct method whereas by concentration method 236 samples (23.6%) from 143 patients were found positive diagnosing additional 54 patients. The gain in sputum smear positivity of 7.8% over the routine method is highly significant (p=0.0000, χ2= 270) with a 10.8% increase in case detection. Conclusions: Improvement in the sensitivity of smears microscopy will be useful in case detection of tuberculosis especially in resource-poor countries. The increased positivity of microscopy by bleach method indicates that would prove useful if included in the RNTCP to improve case detection. Keywords: Concentration; smear positivity; sodium hypochlorite; tuberculosis.

Background: Staphylococcus aureus is a dynamic and adaptable bacterium that has an incredible talent to attain antibiotic resistance. Nasal colonisation of S.aureus increases with greater exposure of students to the hospital environment. The prevention of staphylococcal infection and reduction of spread and emergence of MRSA are essential. Medical students would be a key target group to introduce awareness of hospital-acquired infections. Therefore, the present study aims at understanding the prevalence of carrier rate of S.aureus and MRSA among Medical students during their clinical postings.Methods: Nasal swabs were taken from 150 medical students. Their Staphylococcus aureus nasal carriage was determined by plating on sheep blood agar and MRSA carriage by to Kirby Bauer Disc Diffusion method using Cefoxitin disc (30 µg).Results: The present study showed a 40% nasal carriage of S.aureus amongst medical students. Of the 60 S. aureus isolates 28%, 36% and 56% isolates were from 1st, 2nd and 3rd year respectively. The colonisation rate of MRSA in the present study was found to be 12.66% amongst the medical students of 6%, 10%, 22% belonged to 1st, 2nd, and 3rd respectivelyConclusions: The nasal carriage of Staphylococcus aureus and methicillin resistant Staphylococcus aureus (MRSA) among medical students increases as their exposure to patient care increases. Medical students should be made aware of the risks of carrying S.aureus and MRSA and educated about the hand washing protocol and safety precautions to be followed while handling patients.