Search

Elizabethkingia meningoseptica a rare pathogen in earlier times has been accused to infect the immunocompromised, preterm neonates, the patients exposed to longterm antibiotics and intensive care units. The apparent resistance of the multidrug Elizabethkingia meningoseptica affects the selection of appropriate antibacterial agents against it. The current study attempts to determine the prevalence of E. meningoseptica infections and consider the sensitivity pattern in a tertiary care hospital. A prospective study of prevalence of E. meningoseptica in a tertiary care hospital from March 2020 to March 2021 i.e over a period of 1 year. Patient clinical data as well as ABST patterns were collected and analyzed. Out of total 1813 patient’s samples E. meningoseptica was isolates from 21 cases (1.15%). Average age was 61.42 years, with males most likely to be infected (52.38%). All the adult patients had underlying diseases, obstructive gall bladder diseases (n=7, 33.33%) which included choledocholithiasis, obstructive jaundice, cholangitis and carcinoma gallbladder. Urinary tract diseases (n=8, 38.09%) which include chronic kidney disease (CKD) and acute kidney disease (AKD), pneumonia (n=11, 52.38%) including urosepsis and other diseases AML (n=1, 04.7%). Susceptibility tests showed 100% in vitro against few antimicrobials like cefepime, meropenem and amikacin which can be utilized to treat most common Gram-negative bacterial infections. Isolates are usually the completely sensitive to minocycline. E. meningoseptica is a rising microbe in intensive care setup due to its resistance pattern.

Introduction- The increasing antibiotic resistance like advent of carbapenem resistant Enterobactarales (CRE), Carbapenem Resistant Acinetobacter baumanii (CRAB) and Carbapenem Resistant Pseudomonas aeruginosa (CRPA) has led to use of toxic and older drugs like colistin for these organisms. But worldwide there is an increase in resistance even to colistin mediated both by chromosomes and plasmids. This necessitates accurate detection of resistance. This is impeded by unavailability of a user friendly phenotypic method for use in routine clinical microbiology practice. The present study attempts to evaluate two different methods- Colistin broth disc elution and MIC detection by Vitek 2 in comparison to CLSI approved broth microdilution (BMD) for colistin for Enterobactarales, Pseudomonas aeruginosa and Acinetobacter baumanii clinical isolates. Methods- Colistin susceptibility of 6013 carbapenem resistant isolates was determined by BMD, Colistin Broth Disc Elution (CBDE) and Vitek2 methods and was interpreted as per CLSI guidelines. The MIC results of CBDE, Vitek 2 were compared with that of BMD and essential agreement (EA), categorical agreement (CA), sensitivity, specificity, very major error (VME), major error (ME) and cohen’s kappa (CK) was calculated. Presence of any plasmid-mediated colistin resistance (mcr-1, 2, 3, 4 and 5) was evaluated all colistin resistant isolates by conventional polymerase chain reaction. Results- Colistin resistance was found in 778 (12.9%) strains among the carbapenem resistant isolates. Klebsiella pneumoniae had the highest (18.9%) colistin resistance by BMD method. MIC of Vitek 2 had sensitivity ranging from 78.2% to 84.8% and specificity of > 92%. There were 171 VMEs and 323 MEs by Vitek2 method, much more than CLSI acceptable range. The highest percentage of errors was committed for Acinetobacter baumanii (27.8% of VME and 7.9% ME). On the other hand the CBDE method performed well with EA, CA, VME and ME within acceptable range for all the organisms. The sensitivity of CBDE method compared to gold standard BMD varied from 97.5%-98.8% for different strains with a specificity of more than 97.6%. None of the isolated colistin resistant organism harbored mcr plasmids. Conclusion- As BMD has many technical complexities, CBDE is the best viable alternative available for countries like India. A sensitive MIC reported by Vitek2 needs to be carefully considered due high propensity for VMEs particularly for Klebsiella spp. Data summary- Supplementary material provides data regarding the comparison of MICs of three different mmethods for all samples. Sheet 1 to Sheet 5 contains data for E.coli, K.pneumoniae, A.baumannii, P.aeruginosa, E. cloacae respectively.

Background Blood group has been stated to be one of the risk factors associated with viral diseases like dengue, hepatitis virus, Norwalk virus and even the coronavirus associated with 2003 severe acute respiratory syndrome (SARS) outbreak. In addition, anti-A antibodies in experimental models have been shown to inhibit the interaction between coronavirus and angiotensin converting enzyme (ACE) receptor of the host target cell, the major receptor involved in viral pathogenesis. Thus, several workers propose an association between ABO blood type and coronavirus disease- 2019 (COVID-19) disease in many previous studies. The present study was undertaken in the Eastern part of India in line with these authors to study the association of ABO blood group of patients with COVID susceptibility and severity. Methods This is a retrospective study over a period of 6 months from June 2020 to November 2020 where patients who underwent quantitative real-time polymerase chain reaction (qRT-PCR) test for SARS-COV2 and having a recorded patient blood group type were considered. The qRT-PCR positive admitted cases were considered as cases, and qRT-PCR negative cases were considered as controls. Data were entered in Microsoft Excel format and analyzed by statistical method to obtain association. Results Consecutively obtained 5000 qRT-PCR positive patients (cases) and 11,700 (controls) were included in the present study. The mean age of cases was higher (54.24 vs. 34. 67) than the controls. Among the cases, the highest number (2379; 47.6%) of samples belonged to A blood group followed by B (1278; 25.6%) while among the control group O blood group had the highest prevalence (4215; 36%). Blood group A had a higher odd of testing positive (Odds ratio-2.552; CI 2.381–2.734; p Conclusion Blood group A is associated with an increased susceptibility to COVID 19 infection than other blood groups. Cases of this blood group are also associated with more critical care needs and a higher viral load on testing.

The emergence of colistin-carbapenem-resistant Klebsiella pneumoniae (CCR-Kp) in bloodstream infection results in high mortality, and virulence factor contributes further to the difficulty of treatment. A total of 158 carbapenem-resistant K. pneumoniae (CRKP) isolates causing bloodstream infection were collected from three Indian tertiary care hospitals during the 9-month study period, of which 27 isolates exhibited resistance to both colistin and carbapenem antibiotics. In this study, all the strains were characterized for antimicrobial resistance, virulence factors and capsular serotypes that facilitate the development of colistin and carbapenem-resistant K.pneumoniae (CCR-Kp) in bloodstream infection. Fourteen isolates displayed extremely drug resistance (XDR), susceptible only to tigecycline, and the remaining 13 isolates displayed multidrug resistance (MDR). The gene prevalence analysis for CCR-Kp isolates showed the predominance of bla(KPC) (81.48%) followed by bla(NDM) (62.96%), bla(VIM) (37.03%) and bla(IMP) (18.51%) genes. The distribution of virulence genes was found to be fimH (81.48%), wabG (59.25%), mrkD (55.56%), entB (48.15%), irp1 (33.33%), and rmpA (18.52%). The capsular serotypes K1, K2, K5 and K54 have been identified in 16 isolates. The absence of plasmid-mediated colistin resistance (mcr) genes implies the involvement of other mechanisms. The ERIC and (GTG)(5) molecular typing methods detected 18 and 22 distinct clustering patterns among the CCR-Kp isolates, respectively. A strong correlation between ERIC and (GTG)5 genotyping method was established with antimicrobial resistance patterns and virulence determinants at P