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Background: Timely preparation and presentation of the annual cumulative antibiogram play an important role in the dissemination of an updated susceptibility pattern to clinicians and thus aid in the appropriate choice of antimicrobials for empirical therapy while minimizing adverse effects and resistance. The study aimed to present and analyze the annual AMR data that may be helpful in designing antibiotic policy. Methods: All clinical specimens routinely submitted to the Department of Microbiology from January to December 2021 for bacteriological culture and antimicrobial susceptibility testing (AST) were included. AST was performed for pathogenic isolates by disc diffusion/agar dilution/broth microdilution methods/VITEK® 2 compact system. All data were entered and analyzed using WHONET 2020 software. Results: A total of 46,629 routine specimens were processed, yielding 5792 non-repeat bacterial isolates. Relatively fewer specimens were received during the first few months when the hospital catered exclusively to COVID-19 patients. The most common bacterial isolates were Escherichia coli (30%), Staphylococcus aureus (21%), Klebsiella sp. (18%), Pseudomonas sp. (10%), Acinetobacter sp. (8%) and Enterococcus sp. (5%). Analysis showed low susceptibility to 3rd generation cephalosporins, fluroquinolones, and cotrimoxazole among Gram negative bacteria. Less than 50% Acinetobacter sp. were carbapenem susceptible. We report high rate of methicillin resistance in S. aureus (74%). Overall susceptibility was much lower in specimens from ICU followed by in-patients and out-patients. Conclusion: Antimicrobial resistance is rapidly assuming the proportions of a pandemic, with several authors calling it "invisible" pandemic. As is evident from the present study, low susceptibilities to all but a few last-resort drugs are leaving few choices for treatment. This mandates effective preparation, distribution, and presentation of annual antibiograms, which will help in formulating hospital antibiotic policy. [ABSTRACT FROM AUTHOR]

Malignant syphilis (lues maligna) is a rare form of secondary syphilis, first described by Bazin in 1859, frequently associated with HIV infection. The resurgence of syphilis in the recent times has been attributed to rise in HIV infection. Malignant syphilis is characterized by the presence of pleomorphic multiple round-to-oval papules, papulopustules, or nodules with ulceration, without central clearing, and occasionally exhibit a lamellate brown to black rupioid crust with prodromal symptoms. We herein report a case of early malignant syphilis in a young immunocompromised patient who was HIV positive and noncompliant to antiretroviral therapy, from Northeast India. The HIV/AIDS epidemic is rising at an alarming rate in this part of the country which has thus led to an increase in the number of other sexually transmitted infections. [ABSTRACT FROM AUTHOR]

The article discusses the case study of the 6-year-old boy, resident of Haryana (India), presented with complaints of high-grade fever and swelling in left thigh for 14 days and the child developed vessel wall injury and was referred to a higher center for cardiothoracic vascular opinion, during the course of treatment, fever subsided, the lesions started healing and no new lesions were seen and antibiotic therapy was completed and the child was discharged on cotrimoxazole and iron supplements.

This study describes the abundance of multidrug-resistant Vibrios associated with marine invertebrate hosts from the Andaman Sea, India. Thirty-eight Vibrio strains were isolated from surface mucus layers of coral Porites, Goniastrea, Pocillopora, Fungia, and eggs of spiny lobster (Panulirus penicillatus). Phenotypically, the majority of strains exhibited growth at a wide range of temperatures, salt tolerance, and diverse nutritional requirements. All the strains had more than 97% 16S rRNA sequence similarity with type species of the genus Vibrio where Vibrio fortis, and Vibrio alginolyticus were predominant. Multilocus Sequence Analysis (MLSA) using eight housekeeping genes namely ftsZ, gapA, gyrB, mreB, pyrH, recA, rpoA, and topA distributed the strains into 6 reported clades i.e., Harveyi, Ponticus, Nereis, Orientalis, Splendidus, and Mediterranei where nearly half of the total strains represented the clade Harveyi, followed by the clade Splendidus. Likewise, the PFGE profile indicated genomic heterogeneity among the strains resulting in their distribution in five major clusters. Resistance to different antimicrobials was tested following the disc diffusion method where all strains were found susceptible to chloramphenicol (30 µg) and resistant to streptomycin (10 µg), vancomycin (30 µg), sulfamethoxazole-trimethoprim (25 µg). Moreover, the resistant phenotype to other antimicrobials confirmed the abundance of multidrug resistance strains in this marine environment. [ABSTRACT FROM AUTHOR]

The occurrence of selected pharmaceuticals (trimethoprim, sulfamethoxazole, chloramphenicol, bezafibrate, ceftriaxone, and naproxen) in two west-flowing tropical rivers (Swarna and Nethravati) of southwestern India is reported for the first time. Water samples were collected during the monsoon and post-monsoon seasons from river water end members and further downstream up to their confluence with the adjacent Arabian Sea. Samples were analyzed using HPLC–MS/MS. Results revealed that there were no significant seasonal variations in concentrations of target analytes in both the rivers. Of the total number of samples analyzed (n = 24), trimethoprim was detected in 100% of the samples, whereas sulfamethoxazole (SMX), chloramphenicol (CAP), ceftriaxone (CTX), and naproxen (NPX) were detected in between 91 and 58% of the samples. Bezafibrate (BZF) was not detected in the samples. Nethravathi river showed higher concentrations of pharmaceuticals than the Swarna river which may be attributed to comparatively larger human population in the basin. Possible impacts of PPCPs on aquatic life offer further scope for study. [ABSTRACT FROM AUTHOR]