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Leuconostoc species, the common saprophytic bacteria are now emerging as one of the important opportunistic pathogens. There are different risk factors such as compromised immunity, use of vancomycin, parenteral nutrition, and contaminated surgical implanted devices to contribute the human infection. We here present one of the unusual fatal cases of bacteremia in a cancer patient who was infected with a vancomycin-resistant strain of L. lactis.

Chryseobacteria formerly known as Flavobacterium are a group of aerobic, nonmotile, catalase, oxidase & indole positive & non-glucose fermenting Gram negative rods. Though not a part of normal human flora, they are found in the nature, primarily in soil and water. Since it can survive in chlorine-treated municipal water supplies & can colonize the sink basins and tap waters of the hospitals, this bacterium may be a potential infectious agent. Contamination of the medical devices containing water (respirators, intubation tubes, humidifiers, incubators for newborns, etc.) in hospital settings may lead to serious infections especially in patients with predisposing diseases, newborns and immunocompromised patients. Despite their low virulence, Chryseobacteria are inherently resistant to many antimicrobial agents including imipenem. Here we have presented a case of septicaemia by C. Indologenes in a child suffering from all.

Introduction: Elizabethkingia meningoseptica, a Gram‐negative non‐fermenting bacterium, is usually associated with neonatal meningitis and other infections, especially in immunocompromised patients. It is a potential nosocomial pathogen and is usually resistant to several commonly used antimicrobials. Case presentation: We here report a rare case of septicaemia caused by E. meningoseptica associated with peritonitis and choledocholithiasis. The patient succumbed in spite of diagnosis and institution of appropriate antibiotics. Conclusion: A prompt diagnosis of infection with E. meningoseptica is important so as to guide the institution of appropriate antibiotic treatment.

Chromobacterium violaceum, a facultative anaerobic proteobacterium, is particularly isolated from water and soil in tropical areas and has been implicated in few infections like septicemia, visceral abscesses, skin and soft tissue infections, meningitis and diarrhea. But urinary tract infection caused by it is very rare. Limited awareness about this pathogen and inappropriate antibiotic therapy contribute to a high mortality rate. Here, we describe an unusual case of urinary tract infection by Chromobacterium violaceum in a young immuno-competent male which was managed aggressively with proper antibiotics as per the culture sensitivity report.

To investigate the infection of hospital- and community-acquired "erythromycin-induced clindamycin resistant" strains or D-test positives of clinical isolates of Staphylococcus aureus (S. aureus) (with and without methicillin resistance) in a hospital.Strains of S. aureus isolated from clinical specimens were subjected to D-test and antibiotic profiling.Of the total 278 isolates, 140 (50.35%) were D-test positives and the rest were D-test negatives. Further, of 140 (100%) positives, 87 (62.14%) and 53 (37.85%) strains were from males and females, respectively. Of 140 (100%) positives, 117 (83.57%) were methicillin resistant S. aureus and 23 (16.42%) were methicillin sensitive S. aureus; of 140 strains, 103 (73.57%) strains from persons with and 37 (26.42%) were without related infections; of 140 strains, 91 (65%) and 49 (35%) were from hospital- and community-acquired samples, respectively. In 140 strains, 118 (84.28%) with comorbidities and 22 (15.71%) without comorbidities cases were recorded; similarly, persons with prior antibiotic uses contributed 108 (77.14%) and without 32 (22.85%) positive strains. These binary data of surveillance were analyzed by a univariate analysis. It was evident that the prior antibiotic uses and comorbidities due to other ailments were the determinative factors in D-test positivity, corroborated by low P values, P=0.001 1 and 0.002 4, respectively. All isolates (278) were resistant to 17 antibiotics of nine groups, in varying degrees; the minimum of 28% resistance for vancomycin and the maximum of 97% resistance for gentamicin were recorded. Further, of 278 strains, only 42 (15.1%) strains were resistant constitutively to both antibiotics, erythromycin resistant and clindamycin resistant, while 45 (16.2%) strains were constitutively sensitive to both antibiotics (erythromycin sensitive and clindamycin sensitive). Further, of the rest 191 (68.7%) strains were with erythromycin resistant and clindamycin resistant, of which only 140 (50.35%) strains were D-test positives, while the rest 51 (18.34%) strains were D-test negatives.In view of high prevalence of D-test positive S. aureus strains, and equally high prevalence of multidrug resistant strains both in community and hospital sectors, undertaking of D-test may be routinely conducted for suppurative infections.

To conduct surveillance of a teaching hospital in a period of 15 months, clinical samples from patients were used for the isolation of pathogenic bacteria. Bacterial isolates were isolated and identifies by standard biochemical procedures. Antibiotic sensitivity test were conducted for each isolates by Kirby-Bauer’s/disc diffusion method. Extended spectrum beta lactamase (ESBL) producers were determined by double disc diffusion synergy test (DDST) and iodometric test. 2547 bacterial isolates were found belonging to 12 species namely: Escherichia coli (954), Staphylococcus aureus (661), Klebsiella pneumoniae (301), Enterococcus faecalis (175), Pseudomonas aeruginosa (121), Acinetobacter sp. (110), Citrobacter sp. (69), Klebsiella oxytoca (51), Proteus vulgaris (43), Proteus mirabilis (31), Enterobacter sp. (27), Morganella sp. (4), in descending order. The isolated bacterial strains were further tested for monitoring resistance to cefepime ceftazidime, cefotaxime, ceftriaxone (all 30 μg/disc) and cefoperazone (75 μg/disc) of the third generation cephalosporins (3GCs). Numbers of resistant isolates were in descending order: Proteus vulgaris (76.7%), Morganella sp. (75.0%), Enterococcus faecalis (71.4%), Pseudomonas aeruginosa (68.6%), Proteus mirabilis (67.7%), Klebsiella oxytoca (62.6%) and Citrobacter sp. (52.1%) cefepime (30 μg/disc) and the rest other bacteria were of lesser resistant values with the least percent value, Escherichia coli (7.7%). Similarly, Citrobacter sp. (91.3%) showed resistance to ceftazidime (30 μg/disc) and 76.8% resistant to cefotaxime (30 μg/disc). Proteus mirabilis showed the highest resistance over all other isolates as 90.3% to ceftriaxone (30 μg/disc) and 80.6% to cefoperazone (75 μg/disc). The resistance values to the tested 3GC antibiotics ranged from 43 to 51%. Conclusion Antibiotics inhibiting β-lactamase production were used with a blithesome control over 12 ESBL bacteria. The 3GC antibiotic group was significantly effective in controlling the GN bacterial strains in this study.