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Background: Sepsis is a potentially life-threatening condition with significant mortality and morbidity. An estimated 48.9 million cases and 11 million deaths occur due to sepsis worldwide. The gold standard for the diagnosis of suspected sepsis patients is blood culture. Aims and Objectives: The aims and objectives of the study are to evaluate the growth of rare microorganisms in blood cultures of intensive care unit (ICU) patients, to determine their antimicrobial susceptibility patterns, and also to assess the associated risk factors in those patients. Materials and Methods: This study was conducted for 1 year (August 2023-July 2024) in our department including blood culture samples from ICU patients and relatively rare microorganisms isolated were included in the study accounting for 40 cases. Blood specimens were cultured in automated BD BACTECTM Fx40 blood culture system and identification of microorganisms and their antimicrobial susceptibility pattern were detected by Vitek2 system. Results: Female patients were more in number than male patients and patients of 0--20 years' age group were most commonly affected. Staphylococcus hominis was most commonly isolated out of all rarely isolated microorganisms. The different parameters for the assessment of sepsis severity in our study were C-reactive protein (CRP), Neutrophil count, D-dimer, Procalcitonin, and quick sequential organ failure assessment (qSOFA) score. Out of all, CRP was most commonly raised among sepsis patients. The most common risk factor involved was prolonged ICU stay. Conclusion: Appropriate collection and processing of blood culture samples can reduce sepsis-related morbidity and mortality manifold. Combination of biomarkers study and qSOFA scoring system can improve diagnosis and monitoring of sepsis patients. [ABSTRACT FROM AUTHOR]

Background: Colistin is an antibiotic with lipophilic and hydrophilic properties, effective against Enterobacterales and non-fermenter bacteria. Due to the emergence of multidrug-resistant Gram-negative bacilli, colistin is being once again reintroduced as a last resort for their treatment. Resistance is caused by mutations and some are plasmid-mediated. Aims and Objectives: The aim of the study was to determine antibiotic resistance patterns in Gram-negative bacilli and to detect colistin susceptibility patterns in multidrug-resistant Enterobacterales and Pseudomonas aeruginosa. Materials and Methods: This prospective cross-sectional study was carried out in the Department of Microbiology, Calcutta National Medical College and Hospital, using standard laboratory protocol and colistin susceptibility was determined by colistin broth disk elution (CBDE) method. Results: Out of a total of 80 patients infected with MDR isolates, 63.75% were male and 36.25% were female. The most common age group affected was 41-60 years. Multidrugresistant (MDR) bacteria were most commonly isolated from urine samples, and Klebsiella pneumoniae was the most common MDR bacteria isolated. Overall, colistin resistance was 7.5% and it was found most commonly in K. pneumoniae. The use of broad-spectrum antibiotics was the most common risk factor for the emergence of MDR bacterial infections, including colistin resistance. Conclusion: The present study detects colistin resistance using a simple method -- "CBDE test" which can be done in resource-poor settings and can guide clinicians to rationally use the medication as it may be used as an alternative treatment option for "Super bugs" and can even be used as the "last resort" in certain scenario. [ABSTRACT FROM AUTHOR]

Background: Worldwide, the emergence of carbapenem-resistant enterobacterales (CRE) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a global concern to public health as they are responsible for several serious infections that lead to elevated treatment expenses, prolonged hospitalization, and a higher mortality rate. Aims and Objectives: To detect Carbapenem resistance in Enterobacterales and Pseudomonas aeruginosa by phenotypic methods such as mCIM and eCIM. To determine synergism between Ceftazidime-Avibactum and Aztreonum in metallobetalactamase producing isolates. Materials and Methods: Total 217 isolates including enterobacterales and Pseudomonas aeruginosa from patient's samples such as urine, pus, blood, wound swab, sputum, and ET tube were processed as per standard protocol during the study period from July 2023 to January 2024 at Calcutta National Medical College, Kolkata. Results: Resistance to carbapenem was observed in 110/217 (50.69%) isolates. Phenotypically, 99/110 (90%) produced metallo-β-lactamase and 11/110 (10%) produced serine carbapenemase by mCIM with eCIM test. MBLs producing organisms were most commonly isolated from blood culture samples. On an average, 76% of the MBL producing isolates shows positive synergy result to the combination of CZA+AT by disk elution method. Conclusion: eCIM and mCIM test was performed for identification of carbapenemase producing CRE and CRPA, which causes serious infection in patients with no definitive treatment. The combination of CZA-AT is a potential treatment option to manage CRE and CRPA-associated infections. [ABSTRACT FROM AUTHOR]

Background: Fever is a symptom, not a disease. It is the non-specific manifestation of several underlying illnesses. Aims and Objectives: The aims and objectives of this study were to determine the serological profile of patients with febrile illnesses, to study their different unusual presentations, and to study patients with coinfections with more than one type of disease. Materials and Methods: Blood samples from 15,000 febrile patients were collected during the study period of 6 months. Different serological tests were performed in our laboratory based on clinical suspicion and in a few patients, more than one type of tests were done. The unusual presentations of different diseases were studied. Results: Various percentages of male and female patients were seen suffering from different types of febrile illnesses. The different positive results out of total tests done for respective diseases were dengue (848/7708), vivax malaria (64/800), falciparum malaria (4/800), leptospirosis (95/798), scrub typhus (77/2433), enteric fever (75/1506), hepatitis B (143/9368), hepatitis C (11/9368), human immunodeficiency virus (HIV) (37/10900), systemic lupus erythematosus (5/158), acute renal failure (66/158), and syphilis (54/583). Different unusual presentations among patients with several diseases were noted, along with their percentages of occurrence. Coinfections among dengue and enteric fever (3%), mixed infection with Plasmodium vivax and Plasmodium falciparum (0.25%), scrub typhus and Leptospira (15.6%), hepatitis B and hepatitis C (0.649%), hepatitis B and HIV (5%), hepatitis C and HIV (8.33%), and syphilis and HIV (27.68%). Conclusion: Dengue fever was found to be the most common of all febrile illnesses. The different unusual presentations of those diseases should suggest an improved clinical suspicion and better diagnostic stewardship. Coinfection was most commonly seen among syphilis and HIV and these data must suggest to always looking for associated illnesses in a patient with a single diagnosis. [ABSTRACT FROM AUTHOR]

Background: Ventilator-associated pneumonia (VAP) is defined as infection of lung parenchyma in patients exposed to invasive mechanical ventilation for at least 48 h. VAP is the second most common hospital-acquired infection with a mortality rate up to 40%. Aims and Objectives: To determine the microbiological profile of VAP-related samples, the demographic profile of patients, and associated risk factors. Materials and Methods: VAPrelated samples including endotracheal tube tip, tracheal secretions, and bronchoalveolar lavage (BAL) fluid were collected from 73 patients during the study period from January 2023 to November 2023. Their blood samples were also collected for automated blood culture. Samples were processed as per standard protocol. Results: Out of the total patients, 60.31% were male and 39.68% were female. 61-80 years was the most commonly affected age group. The most commonly isolated micro-organism was Acinetobacter baumannii with the highest sensitivity to polymixin B and tigecycline. Associated blood culture positivity was maximum in patients whose samples of ET tube tip, tracheal secretions, and BAL fluid had isolated A. baumannii and Klebsiella pneumoniae. Two Candida albicans were isolated with sensitivities to voriconazole and amphotericin B. Many patients had associated septicemia. Endotracheal intubation and tracheal suction were the most common risk factors associated. Conclusion: As associated septicemia may increase the mortality rate manifold blood samples should also be collected in suspected VAP patients along with VAP-related samples for early detection of sepsis leading to better patient management. [ABSTRACT FROM AUTHOR]

This article presents the findings of a study conducted in a tertiary care hospital in India on tuberculosis (TB) positivity and rifampicin resistance rates in different clinical samples. The study found that sputum had the highest TB positivity rate, while rifampicin resistance was more common among pulmonary samples. Risk factors associated with TB included smoking, diabetes, HIV infection, and post-COVID infection. The study concludes that the Truenat MTB/RIF assay is an effective tool for early diagnosis and treatment of both pulmonary and extrapulmonary TB. The article also mentions other related studies on sputum culture positivity and rapid diagnosis of Mycobacterium tuberculosis. [Extracted from the article]

Background: Abscess, an infection with viable infecting organisms and polymorphonuclear cells, contained within a fibrous capsule, limiting the infection, and preventing its further spread. It may be monomicrobial or polymicrobial. Aims and Objectives: The aims of the study were to determine microbiological profile of abscesses of different body sites and associated complications. Materials and Methods: An observational study was conducted in our department with 35 pus samples from abscesses of different body sites between August 2022 and December 2022. Gram stain, Z-N stain, fungal stain, aerobic, anaerobic, and fungal culture were performed. Statistical analysis was done by statistical tool R. Results: Out of 35 sampleslimb, liver, paraspinal, psoas, appendicular, breast, perineal, ear, brain and lung abscesses were 11,4,2,3,1,7,2,2,2,1 respectively. Most common organisms from limb, ear, paraspinal and breast abscesses was MRSA (Methicillin resistant Staphylococcal aureus). Also most common organisms were - Escherichia coli from liver abscess, Enterobacteriaceae and Pseudomonas aeruginosa from psoas and appendicular abscess, Enterobacter aerogenes from perineal, Escherichia coli and Actinomyces species from brain and Candida auris from lung abcesses. No growth were also found in few samples. Their susceptibility testing showed-MRSA strains susceptible to both Vancomycin and Linezolid, gram negative bacteria were susceptible to Cephalosporins, Piperacillin-tazobactam, Carbapenems, polymixins, etc. C.auris was resistant to all antifungals. Their blood samples were also collected - ten patients showed fever with bacteremia and one with candidemia. They were treated with systemic antimicrobials along with drainage and/or surgical resection. Conclusion: Abscesses must be suspected in cases with non-resolving fever with/without septicemia and treated promptly with appropriate antimicrobials based on susceptibility report and with drainage and/or surgical resection. [ABSTRACT FROM AUTHOR]

Byline: Chand. Wattal, Yash. Javeri, Neeraj. Goel, Debashish. Dhar, Sonal. Saxena, Sarman. Singh, Jaswinder. Oberoi, B. Rao, Purva. Mathur, Vikas. Manchanda, Vivek. Nangia, Arti. Kapil, Ashok. Rattan, Supradip. Ghosh, Omender. [...]