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Introduction: One of the rapidly escalating public health problems worldwide is traumatic brain injury (TBI) due to road traffic accidents. In comparison to postneurosurgery patients and other patients inhabiting the intensive care units (ICUs), patients with TBI are more susceptible to nosocomially acquired infections from the hospital milieu. Methods: This retrospective study was conducted at a university hospital in Northern India from December 2018 to September 2022. All patients presenting with TBI formed the cohort of our study population. Results: A total of 72 patients with TBI were enrolled. The mean age of patients was 40.07 ± 18.31 years. The most common infections were ventilator-associated pneumonia (VAP) (44/72, 61.11%) and bloodstream infection (BSI) in 21 (21/72, 29.17%) patients. Concomitant infections were observed in 21 (21/72, 29.17%) patients. The common organism causing VAP was Acinetobacter spp. (29/58, 50.0%), BSI was Klebsiella pneumoniae (10/23, 43.48%), urinary tract infection was K. pneumoniae (5/16, 31.25%), and surgical site infection was Acinetobacter spp. (3/8, 37.5%) in TBI patients. An increased incidence of multidrug resistance was demonstrated in our patients. The increased length of hospital and ICU stay, ICU admission, intubation, diabetes mellitus, chronic kidney disease, and hypertension were statistically significant parameters that made TBI patients prone to develop an infection. Conclusion: TBI patients suffering from underlying comorbidities are prone to develop infections with multidrug-resistant bacteria was observed among our study cohort which also mirrors the lack of adherence to infection control measures. [ABSTRACT FROM AUTHOR]

Background: Achromobacter causes opportunistic nosocomial infections in immunocompromised patients with high mortality. It is underreported as it is often misidentified by conventional microbiological methods. Aims: The aim of the study is to access the clinicomicrobiological profile and antibiogram of Achromobacter spp. from clinical isolates. Materials and Methods: It is an observational study done from July 2020 to December 2021 in our hospital. All nonduplicate isolates of Achromobacter from blood and respiratory samples were initially identified with VITEK-2 GN card system and further confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiogram and treatment outcomes were also studied. Results: Achromobacter spp. was isolated from 14 patients. Blood samples yielded most isolates (71.4%; n = 10) followed by tracheal aspirate and bronchoalveolar lavage fluid. Bacteremia followed by pneumonia was the most common clinical manifestation of Achromobacter infection. All the isolates were identified as A. xylosoxidans denitrificans and showed 100% susceptibility to minocycline and piperacillin-tazobactam. Diabetes mellitus and malignancy were the most common underlying condition in these patients. A favorable outcome was seen in 78.6% of the individuals with timely institution of antibiotics and proper diagnosis. Conclusion: Infections due to Achromobacter are on the rise in developing countries like India. Resistance to many classes of antimicrobials makes its treatment more challenging therefore it should always be guided by antibiograms. The present study highlights the significance of this rare bacterium in patients with malignancies in India and advocates greater vigilance toward appropriate identification of this organism. [ABSTRACT FROM AUTHOR]

Context: Knowledge of epidemiology of bacterial isolates and their anti-biograms in hospital settings is necessary for prompt empirical anti-microbial therapy of neonatal sepsis. Aims: To study risk factors, bacteriological profiles, and anti-biograms of blood culture isolates of both early and late onset neonatal sepsis. Settings and Design: It is a prospective observational study conducted from January 2020 till July 2021 at our tertiary care center. Material and Methods: Neonates (0–28 days) admitted to this neonatal intensive care unit clinically suspected with sepsis were subjected to blood cultures, and the isolates were identified both biochemically and by the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry system. Antibiotic susceptibility testing (AST) was performed as per CLSI guidelines. Statistical Analysis: Chi-square test was used. Results: Out of 280 suspected cases of neonatal sepsis, 43 (15.3%) cases showed positive blood culture. Of these, the majority (30, 69.8%) had late-onset neonatal sepsis. Major pre-disposing risk factors were pre-term birth and a low birth weight (26, 60.5%). Gram-negative bacteria and Gram-positive bacteria were isolated in 25 (58.1%) and 18 (41.9%) blood cultures, respectively. Klebsiella pneumoniae (37.5%) was the most predominant pathogen in both early-onset (23.1%) and late-onset (46.7%) sepsis. Coagulase negative Staphylococcus (34.8%) was the second most common organism and was more common in late onset (23.2%) neonatal sepsis. A high level of antibiotic resistance was noted in Klebsiella pneumoniae isolates, even to amikacin (76.5%) and carbapenems (66.7%). Conclusion: Increased resistance in bacterial isolates of neonatal sepsis emphasizes the need of AST of bacterial isolates for proper antibiotic administration. [ABSTRACT FROM AUTHOR]