Elizabethkingia meningosepticum is a saprophyte which exists in hospital water systems and it can be a potential source for nosocomial infections. Though the infection with these bacteria is rare, one should be aware that it is resistant to most of the antibiotics and that it has the ability to cause nosocomial infections. We are reporting here, a series of cases which were caused by E. meningosepticum.

Background:Enteric fever is caused by the serotypes Salmonella Typhi, Salmonella Paratyphi A, Salmonella Paratyphi B and Salmonella Paratyphi C. After emergence of multidrug resistant Salmonellae Ciprofloxacin, a fluorquinolone antibiotic was the first-line therapy. Treatment failure was observed with Ciprofloxacin soon and such strains showed in-vitro resistance to Nalidixic acid. Recent reports suggest re-emergence of Chloramphenicol sensitive strains and increasing Nalidixic acid resistance. This study is aimed at detecting the current trend in the antibiogram of Salmonella isolates from blood culture in coastal Karnataka, with an emphasis on antibiotic susceptibility of Nalidixic acid and Chloramphenicol and evaluate, if there is a need to modify the strategies in the antibiotic therapy for enteric fever.Materials and Methods:Blood samples received for culture in the laboratory between June 2009 and August 2011 was cultured in Brain Heart infusion broth, bile broth or in a commercial BACTEC culture media. The growth from blood cultures were processed for identification and antibiotic susceptibility as per standard methods. Antibiotic susceptibility for Ampicillin, Trimethoprim-sulphamethoxazole, Chloramphenicol, Ciprofloxacin, Ceftriaxone and Nalidixic acid were noted.Results:Out of 9053 blood culture specimens received, Salmonella was isolated from 103 specimens. There were 85 Salmonella Typhi isolates, 16 Salmonella Paratyphi A and two Salmonella Paratyphi B. Salmonella Typhi and Salmonella Paratyphi A showed the highest resistance to Nalidixic acid. Salmonella Typhi showed highest susceptibility to Ceftriaxone and Salmonella Paratyphi A to trimethoprim-sulphamethoxazole and Chloramphenicol. Two isolates were multidrug resistant. One Salmonella Paratyphi A was resistant to Ceftriaxone.Conclusion:Routine screening of Nalidixic acid susceptibility is practical to predict fluorquinolone resistance in Salmonella and preventing therapeutic failure while treating with it. It is worthwhile to consider replacing fluorquinolones with Chloramphenicol or Ceftriaxone as the first line of therapy for enteric fever. Periodic analysis of Salmonella antibiogram should be done to formulate the best possible treatment strategies.

Tuberculosis (TB) of the genital tract commonly occurs secondary to a primary lesion. The mode of spread is via the lymphatics, the haematogenous route or less commonly by a peritoneal spread. The fallopian tubes are the first targets, followed by the pelvic organs. Isolated cases of TB which occur in a unilateral fallopian tube are rare, particularly with it as a primary site. The aim of this study was to report a rare case of TB of the left fallopian tube in a post menopausal lady with no positive history, clinical or laboratory finding to suggest it to be a secondary focus. As the pre-operative diagnosis was that of a right ovarian neoplasm, the patient underwent staging laparotomy. TB of the left fallopian tube was diagnosed, as there were numerous typical granulomata throughout the fallopian tube.

Aim is to present a rare case of purulent pericardial effusion caused by Burkholderia pseudomallei. Pericardial sample was inoculated into Bactec Peds Plus/F broth of the Bactec automated system. After the system flagged positive, the broth was subjected to Gram stain, biochemical tests and drug susceptibility. The organism was identified as Burkholderia pseudomallei. Tuberculosis (TB) is the most common cause of pericarditis in countries where it remains a major public health problem, but in the western coastal districts of India, clinicians and microbiologists alike must be aware of Burkholderia pseudomallei a rare cause of pericarditis that can be misdiagnosed as TB pericarditis.

A 48 -year -old female, resident of Kasargod, rural area in Dakshina Kannada,India, was admitted with complaints of high grade fever with chills, epigastric pain and cough with expectoration since 2 weeks and oliguria since 2 days. General examination revealed fever, icterus, conjunctival suffusion, pedal edema and facial puffiness. On systemic examination, there was diffuse tenderness and guarding over the abdomen, bilateral coarse crepitations over the chest region. Abdominal ultrasound revealed hepatomegaly, bulky spleen and right basal consolidation. X-Ray findings of chest were suggestive of pulmonary haemorrhage. Blood investigations were within normal range. Blood and urine cultures were sterile. RA factor was 376IU/ml, ASO titre was 202.3IU/ml, ESR-51mm.The patient was shifted to intensive care unit after two days of admission in the view of decreasing renal functions, tachypnoea and metabolic acidosis. Peripheral smear for malaria and for serology for dengue were negative. Patient was reactive for HBsAg by both rapid screening and ELISA ( HEPLISA J.Mitra

BACKGROUND Over the past decade, there has been a significant increase in the number of reports of systemic and mucosal yeast infections. These infections have a direct impact on the choice of empiric antifungal therapy and clinical outcome. The aim of the study is to determine the risk factors and characterisation of the yeasts from various clinical specimens. MATERIALS AND METHODS In a prospective study, a total of 200 yeasts isolated from various clinical specimens were processed and identified up to species level by germ tube test, growth on corn meal agar, sugar fermentation and assimilation test, India ink preparation, urease test and Candida differential agar. The demographic data and risk factors were recorded. Statistical Analysis-The data was analysed in terms of frequency percentage. RESULTS Candida species was the most predominant (97%) among the yeasts. Majority of the isolates were C. tropicalis (44%) followed by C. albicans (34%), C. glabrata, C. krusei, C. parapsilosis, Cryptococcus neoformans, C. dubliniensis, C. kefyr and Trichosporon asahii. Diabetes, broad-spectrum antibiotic therapy, prematurity, malignancy, steroids and AIDS were the risk factors. CONCLUSION There is increase in prevalence of non-albicans Candida species and increase in incidence of disseminated cryptococcosis in HIV seropositive patients. Thus, early isolation and speciation will aid the clinicians to institute proper antifungal therapy, thus decreasing morbidity and mortality.

BACKGROUND Candida blood stream infections have increased drastically by 2 to 5 folds in a tertiary care hospital over the past decade. In spite of advances in diagnosis and treatment, candidaemia is one of the major cause of morbidity and mortality in healthcare facility. The changing antifungal spectrum of Candida blood stream infection has generated great concern about the emergence of drug resistance strains of azole and its clinical outcome. The aim of the study is to speciate and determine the antifungal susceptibility testing of candida species isolated from bloodstream infection by use of VITEK 2 system. MATERIALS AND METHODS In a prospective study, a total of 50 Candida species isolated from bloodstream infection were subjected to identification and antifungal susceptibility testing by VITEK 2 automated system. RESULTS Among the 50 Candida blood isolates, C. tropicalis was the predominant strain isolated in 22 (44%) isolates, followed by C. albicans in 15 (30%), C. glabrata in 7 (14%), C. krusei in 3 (6%), C. parapsilosis in 2 (4%) and C. kefyr in 1 (2%) isolate. All the C. albicans showed 100% susceptibility to fluconazole, voriconazole, flucytosine and amphotericin B. C. glabrata showed 100% resistance to azoles. C. krusei showed 100% resistance to fluconazole. A 4.5% C. tropicalis showed resistance to amphotericin B. CONCLUSION The successful treatment of Candida infections in blood depends on the rapid identification of the species and sensitivity patterns to antifungal agents. VITEK 2 system is a valuable tool for identification and AST as it is rapid and less cumbersome. Amphotericin B and voriconazole seem to be suitable drugs for empirical therapy in severe cases and fluconazole is not suitable because most of the Candida species are resistance to them.