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Faecal carriage of Carbapenem-resistant Enterobacteriaceae (CRE) is being observed as an important risk factor for bacteremia among patients with hematological malignancies. A prospective surveillance study was conducted among these patients to determine the gut colonization of CRE. Rectal/perianal swabs were collected to isolate CRE. Carbapenem resistance was detected by disk diffusion, modified-Hodge, Carba-NP test, and PCR for blaNDM-1, blaKPC, blaOXA-48, blaVIM, blaIMP genes. A total of 209 CRE isolates were identified from 151 patients. E. coli was the most common (83.2%) CRE identified, followed by Klebsiella spp. (9.6%). The majority of CRE were observed resistant to ertapenem (86%). blaNDM-1 was the most common gene (57.3%), followed by blaOXA-48 (37.8%). 26.8% isolates found to carry both blaNDM-1 and blaOXA-48 genes. CRE is increasingly observed to cause bacteremia among hematological malignancy patients due to increased colonization. Screening for gut CRE colonization is necessary to guide empirical therapy and apply infection control measures among these patients.

Introduction: Detection of carbapenem resistance in the clinical microbiology laboratory is challenging. Production of carbapenemase enzymes remains the most important mechanism among Carbapenem Resistant Enterobacteriaceae (CRE). Ertapenem has been found as a sensitive marker for detecting CRE, especially the non-carbapenemase producing CRE. However, limited literature is available discussing its specificity and sensitivity in comparison to gold standard tests. Aim: To compare the ability of the ertapenem disc diffusion test with other confirmatory tests i.e., Epsilometer test (E test), Carbapenemase Nordmann-Poirel (CNP) test, and Polymerase Chain Reaction (PCR) for CRE identification. Materials and Methods: Seventy six phenotypically confirmed Enterobacteriaceae isolates were tested for carbapenem resistance. Ertapenem susceptibility was compared with imipenem, meropenem, and doripenem disc individually and in combination to determine its sensitivity. Further, it was compared with the E test, CNP test, and PCR to find the concordance of the result. Data were analysed by statistical software using Chi-square test with p-value

CD38 on CD8 + T cells is considered a reliable marker of HIV disease progression. Withania somnifer, a traditional ayurvedic medicine, has Th1 immunomodulatory properties. PBMCs from 38 HIV patients were exposed to Withania somnifer root extract at standardized concentration. An overall decline in the percentage of CD38 expressing CD8 + T lymphocytes was observed, though the statistical significance was varied with different categories of HIV patients. Withania somnifer could have promising impact on HIV disease and therefore warrants a further study on larger parameters.

BACKGROUND: The prevalence of carbapenem‐resistant Enterobacteriaceae (CRE) is alarming worldwide causing serious infections. Rapid and accurate identification of CRE is crucial to reduce the mortality and morbidity. In this study, we tried to develop an in‐house Carba NP test for detection of CRE and evaluate its performance with others. METHODS: A prospective study was conducted with 40 nonrepeating Enterobacteriaceae isolates over a period of 3 months. All the isolates were screened for carbapenem resistance as per CLSI 2016 guidelines followed by PCR for blaNDM‐1, blaOXA‐48, blaKPC, blaVIM, and blaIMP genes. All the isolates were subjected to five phenotypic tests, that is, in‐house Carba NP (iCarba NP), commercial Carba NP (cCarba NP), Blue‐Carba, modified Hodge test (MHT), and CHROMagar. RESULTS: Among the 40 isolates, 87.5% were identified as Escherichia coli, 7.5% were Klebsiella pneumoniae, 2.5% were Enterobacter cloacae, and 2.5% were Citrobacter freundii. Thirty‐three of 40 (82.5%) isolates were found to harbor one or more resistant genes. Considering PCR to be the gold standard test, sensitivity of the phenotypic methods for CRE detection ranged from 63.6% (MHT) to 96.9% (CHROMagar). Both cCarba NP and iCarba NP observed to have highest specificity. The performance of iCarba NP was found comparable with cCarba NP by kappa score 1 and found approximately 10 times less expensive than cCarba NP. CONCLUSION: CHROMagar was observed most sensitive assay for detection of CRE followed by both Carba NP tests. iCarba NP was proved cheaper and equally good as cCarba NP for detection of CRE.