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Background- Community acquired urinary tract infection (CA-UTI) is the second most common infection in the community. The etiology and antimicrobial susceptibility of the uropathogen vary widely with time and space. Although its forms the basis of the empirical of CA-UTI yet it has not been showed extensively in India. Methods- The study was conducted for 6 months. Urine samples of clinically suspected UTI patients attending OPD were collected and direct microscopy and cultures were done. Antimicrobial susceptibility was performed on the all bacteria by Kirby Bauer's disk diffusion method. Results- CA-UTI prevalence was 60.5% in patients. However, the prevalence was signicance in the female patients than male (females 66.1% and males 33.9%). Prevalence of gram negative bacteria (91%) over the gram positive bacteria (9%) only causes the CA-UTI. The majority of infections were due to Escherichia coli (63.2%). Most of the uropathogen are resistance to the ampicillin and cephalosporin and least infection to colistin/ polymyxin-B. In the gram positive bacteria they are suspectible to vancomycin and linezolid. Conclusion- The empirical therapy to treat CA-UTI should be chosen from amongst the antimicrobial agents who show sensitivity to these uropathogens after culture and sensitivity.

Background: Skin mycoses also called dermatophytosis is the most common fungal infection affects 20-25% of World population. Its prevalence varies place to place with climatic changes, time to time with age, sex and lifestyle of the population. Dermatophytoses could be caused by dermatophytes and non-dermatophytes, their frequency of isolation differs with geographical variation. Objectives: To study various clinical presentations of skin mycosis and compare KOH with culture in the diagnosis of dermatophytic infections in a tertiary care hospital. Material & Methods: A total of 98 skin scrapings collected from consecutive OPD patients from 1st June 2016 to 31st May 2017 examined using KOH and culture on modified Sabouraud’s dextrose agar medium. The isolated fungi were identified by morphology, lactophenol cotton blue, slide culture and biochemical tests. Results & Discussions: T. corporis (40.82%) was the most common clinical presentation followed by T. cruris (17.35%), T. pedis (15.31%), T. capitis (8.16%). Fungal infections were demonstrated in 52/98(53.06%). The male to female ratio of the positive cases was 15:9. The most affected age group in males 30-40yrs and females 40-50yrs. KOH positive were 43.87% (43/98). The samples which were positive in both KOH and culture were 17.35% (17/98), those positive in KOH and culture negative were 26.53% (26/98) and KOH negative and culture positive were 7.14% (7/98). Out of 24 positive cultures, 21 were dermatophytes and three were non-dermatophytes. The most common dermatophytes were T. mentagrophytes (62.5%) followed by T. rubrum (20.8%) and M. gypseum (4.33%). Conclusion: Skin mycoses is caused mainly by dermatophytes (T. mentagrophytes followed by T. rubrum) but non-dermatophytic infections do occur. Therefore, fungal culture is imperative for correct diagnosis and proper treatment.

Otitis externa is a common condition encountered in the ENT outdoors. For long, it was thought to be of fungal etiology but after World War II, bacterial pathogens were found to be most commonly involved. Pseudomonas has been described as the most common causative organism in the literature. This prospective study aimed to study the microbiological profile and antibiotic sensitivity of 100 patients of otitis externa. 100 diagnosed cases of otitis externa were included in the study after informed consent. Swabs were taken from the external acoustic canal maintaining asepsis. The swabs were analysed using microscopy, culture and sensitivity testing. The samples were cultured on blood agar, MacConkey agar and Sabourad’s dextrose agar with antibiotics. Antimicrobial susceptibility testing was done by Kirby–Bauer disc diffusion method. The most common bacteria identified was Pseudomonas aeruginosa (36.36%), followed by Staphylococcus aureus (15.45%), Escherichia coli (2.73%), Klebsiella (1.82%), and Proteus sp (1.82%). Aspergillus sp (19.09%) and Candida albicans (8.18%) were the fungal species identified. Pseudomonas showed excellent sensitivity to imipenem, piperacillin and ofloxacin, while Staphylococcus showed good sensitivity to vancomycin, ofloxacin and netilmycin. Topical fluoroquinolones can be used as empirical treatment in most cases of bacterial otitis externa. In resistant cases, culture and antibiotic sensitivity should be done to manage the infection.

Background: Asymptomatic bacteriuria (ASB) is common in neonates, preschool children, pregnant women, elderly, diabetics, catheterized patients, and patients with abnormal urinary tracts or renal diseases. Though there is currently no consensus on treatment of ASB in various population groups, it is advisable to treat the same in patients with diabetes mellitus (DM). Aims: To determine the prevalence of ASB in patients with type 2 DM and to study the spectrum of uro-pathogens causing ASB along with their antibiotic susceptibility profile. Settings and Design: This prospective, observational study was conducted in the department of Medicine of a tertiary care teaching hospital. Methods: The study was conducted on 100 patients with type 2 DM. Urine wet mount and gram stain examination was done for all to detect the presence of pus cells and bacteria in urine. Antibiotic sensitivity testing was performed in patients with significant bacteriuria to determine the sensitivity profile of isolated uro-pathogens. The data were analyzed to determine the association between diabetes and ASB. Results: ASB was common among diabetics, as evident by a prevalence of 21%. Presence of ASB showed positive correlation with poor glycemic control. Escherichia coli (E. coli) was the most common organism causing ASB followed by Candida, Pseudomonas, Klebsiella, and Citrobacter. E. coli isolated from study patients was most sensitive to imipenem and nitrofurantoin (NFT). Conclusions: ASB is common among diabetics, with poor glycemic control being a significant risk factor. E. coli is the most common organism causing ASB in diabetics, and it is most sensitive to imipenem and NFT.

Background: Tuberculosis (TB) is the most common presenting illness and leading cause of death among people living with HIV(PLHIV). Diagnosis of TB among PLHIV is challenging as false negative results are common with direct microscopy (DM) and culture takes long time. WHO (2013) recommended Xpert MTB/RIF assay as an initial test for diagnosis of TB in PLHIV. Methods: The present study was conducted on 142 HIV seropositive patients who were clinically suspected to have TB. The sputum specimens obtained from these patients were divided into two parts; one was processed by DM and the other was used for Xpert MTB/RIF assay. Result: Of the 142 HIV seropositive patients, 90(63.3%) were in the age group of 15-40 years and majority 91(64.08%) were males. Out of 142 sputum specimens collected from these patients, only 5(3.52%) were positive by DM and 31(21.83%) by Xpert MTB/RIF assay. Statistically the difference between the two was significant (p value

INTRODUCTION: Resistance to antimicrobial agents is a major concern worldwide and is exemplified by the global spread of the Methicillin resistant Staphylococcus aureus (MRSA). Health care workers (HCWs) and asymptomatically colonized patients are important sources of nosocomial MRSA infections. AIMS AND OBJECTIVES: To determine the prevalence of MRSA colonisation, two hundred HCWs and 200 consecutive outpatients attending our tertiary care hospital were studied. MATERIALS AND METHODS: Two sterile pre-moistened cotton tipped swabs were used to collect specimens from their anterior nares. These were inoculated immediately on Blood agar with oxacillin, Mannitol salt agar with oxacillin and CHROM agar. Resistance to cefoxitin was confirmed by PCR by demonstration of mecA gene. Antibiotic susceptibility was determined by Kirby Bauer’s disc diffusion method and MIC of vancomycin by using broth dilution and Vitek-2 Compact system. RESULTS: The nasal carriage of MRSA among HCWs was found to be 7.5% and in outpatients 3%. All strains of MRSA from HCWs and outpatients grew on three selective media and mecA gene amplified in all of them. All the isolated strains of MRSA showed high degree of resistance to co-trimoxazole (93.3%), ciprofloxacin (80%) and erythromycin (66.66%). However, there was 100% susceptiability to vancomycin, teicoplanin, linezolid and Rifampicin. CONCLUSION: Although a direct casual relationship could not be established, it could be assumed that the transmission from colonised health care worker is responsible atleast in part for MRSA infection among patients. Therefore emphasis should be laid on strict implementation of standard infection control practices which would help in minimizing the carriage and transmission of MRSA in the hospital.

Recently, an increase in the incidence of infections caused by fungi especially non-albicans Candida species has been reported. Several virulence factors like biofilm formation, toxin production and presence of adhesins contribute to its pathogenesis. This study was undertaken to determine species distribution, biofilm formation and in-vitro antifungal susceptibility of Candida isolated in our tertiary care hospital. One hundred and forty-two clinical isolates obtained from various clinical specimens were subjected to KOH smear and cultured on Sabouraud’s Dextrose agar medium. Conventional methods and automated identification system (Vitek 2 Compact) for yeast identification were done. Biofilm forming ability of each isolate was detected using microtitre plate method. Antifungal susceptibility against fluconazole, voriconazole, flucytosine, amphotericin B and caspofungin was tested using Vitek 2 Compact. Out of 142 Candida isolates, 90 (63.4%) were C. albicans and 52 (36.6%) were non-albicans Candida species. Among 52 non- albicans Candida, C. parapsilosis was found in 20 (38.5%) cases followed by C.tropicalis 16 (30.8%). Among all isolates, 52 (36.6%) were biofilm producers and biofilm positivity was more among non-albicans Candida 28 (53.8%) as compared to C. albicans 24 (26.7%) (p-value

Introduction: Human Papillomavirus (HPV), a small circular double stranded DNA virus is the major aetiological agent of cervical precancerous and cancerous lesions. Genital HPV types are divided into high and low risk types, according to their oncogenic potential. The proportion of women infected with HPV varies greatly across populations as is the distribution of HPV genotypes. Aim: The present pilot study was conducted to determine the most frequent genotypes of HPV associated with: a) Histologically proven cases of cervical carcinoma; b) Women with normal cervical cytology. Materials and Methods: The present hospital based crosssectional study was conducted on 132 women attending Obstetrics and Gynaecology department of a tertiary care hospital. Consecutive cervical brushings were collected from women presenting with any type of cervical lesion and were subjected to cytology, histopathological examination, HPV DNA testing and genotyping by using Sacace real time PCR. Results: Of the 132 women studied between January 2014- October 2014, 50 (37.87%) had histologically proven cervical carcinoma and 82 (62.12%) had normal cytology. In proven cases of cervical carcinoma, HPV infection was found to be associated in 49/50 (98%) and all of them had high risk HPV genotypes. The most common genotypes were 16 (67.34%) and 18 (20.4%). Other genotypes present were 45 and 33. Out of 82 cytological normal women, five showed presence of HPV DNA on RT PCR. While all the five had infection of HPV genotype 18, in one there was presence of both 16 and 18 genotypes. Conclusion: The detection of HPV genotypes 16, 18 along with high risk type 33 and 45 in Malwa region of Punjab confirm the importance of identifying the types of HPV that infects this community to design more effective prevention strategies and thus contribute to fight against cervical cancer.

Background: Hepatitis C virus (HCV) infection is high in state of Punjab, however very few studies have been done till date. We all know that pregnant females are a most important section of our community and are usually screened for HCV, HIV, and Hepatitis B at time of presentation. HCV is capable of causing chronic infections and having long-term implications on a person's health. Vertical transmission of HCV can be one of the major route of transmission of this virus to the neonate and there have been various sociodemographic factors like age, literacy, socioeconomic status, occupational status, associated with the disease causation and transmission. Methods: All pregnant females attending Obstetrics and gynecology department of our institute were included in study. All the sociodemographic characters and socioeconomic records were retrieved and analyzed. Results: In our study also a lower socioeconomic status, illiteracy have been significantly associated with the HCV-positive group, thus emphasizing the role of education so as to impart education to the masses as regard to mode of transmission and its effects on the disease. Higher age of conceiving is also significant associated with the increased maternal risk. Conclusions: The more involvement of health care officials and even persons not related to health care set up is required who can educate masses so as to protect the community.

Background: Xpert MTB/RIF assay has revolutionized the diagnosis of tuberculosis (TB) by simultaneously detecting the bacteria and resistance to rifampicin (RIF), a surrogate marker for multidrug-resistant TB (MDR-TB) in Materials and Methods: A total of 1612 specimens received between October 2013 and February 2015 were tested by Xpert MTB/RIF assay following manufacturer’s instructions. The results thus obtained were analyzed using SPSS version 20.0.0 (SPSS Inc., Chicago, IL, USA) statistical software. Result: RIF resistance was statistically higher in previously treated patients in comparison to the new patients (P = 0.006) and in patients with acid fast-Bacilli (AFB) positive smears to AFB-negative smears (P = 0.048). RIF resistance mutations in 130 specimens revealed frequency of E 73/130 (56%), B 28/130 (21.5%), D 18/130 (13.8%), A 11/130 (8.4%), and C 1/130 (0.7%) while in one specimen, mutation combination, i.e., mutations associated with more than one probe (A and B both) was present. Conclusion: Xpert MTB/RIF assay is a user-friendly screening tool for detection of MTB and RIF resistance from suspected TB/MDR cases in a shorter period of time. It could also serve as a useful technique to have simultaneous preliminary information regarding the mutation pattern of RIF resistance in MTB isolates.

Objective To compare the efficacy of rapid immunochromatographic test (ICT) and ELISA for detection of dengue specific parameters (NS1 antigen and IgM antibodies) and the association of these parameters with thrombocytopenia. Methods A total of 1787 serum samples were obtained from the same number of clinically suspected cases of dengue during an outbreak (2011) of dengue in the Malwa region of Punjab. All the samples were subjected to rapid ICT, dengue early ELISA and dengue IgM-capture ELISA for detection of NS1 antigen and IgM antibodies. Platelet counts of all the cases positive for dengue infection and 150 cases negative for dengue parameters (control group) were recorded. Resutls Rapid ICT for NS1 antigen detection showed same specificity (100%) but lower sensitivity (85.81%) than the dengue early ELISA, while it was 100% and 94.10% respectively for IgM antibody detection. The difference in the platelet counts of cases positive and negative for dengue specific parameters was stastically insignificant (standard error of proportions=0.017, Z value=0.84, P value=0.2). Conclusions The confirmation of serological diagnosis of dengue should always be based on ELISA test and ICT and/or thrombocytopenia should not be used as a stand-alone test.

Aim: Malaria remains an enormous public health problem. Regular and ongoing surveillance to detect changes in its trends to initiate the control measures is the need of the hour. The present study was undertaken to provide the malaria transmission dynamics using surveillance indicators through active and passive surveillance in district Faridkot. Usefulness of rapid malaria diagnostic test was also evaluated. Methodology: This retrospective study extended over a period of two years (2010-2011). Thick and thin blood smears were prepared from suspected cases of malaria complaining of fever and headache for the last three days (i) of 2 CHC’s, 8 PHC’s and 68 sub centers as a part of active surveillance and (ii) those who visited GGS Medical College & Hospital and civil hospital Faridkot as a part of passive surveillance. Out of all the samples collected during the passive surveillance 995 samples collected at GGS Medical College and Hospital, Faridkot were also subjected to rapid diagnostic test (OptiMAL). Results: The annual blood examination rate (ABER) was 9.0 and 9.7 in 2010 and 2011 respectively. Annual parasite incidence (API) recorded was < 2 (0.5) in both the years and slide positive rate (SPR) was 0.5 and 0.05 in the two respective years of study. Significant gap in the rate of case detection of active and passive surveillance systems was observed with predominance of passive surveillance. More than 96% of cases were of P. vivax. Research Article British Microbiology Research Journal, 3(3): 339-345, 2013 340 RDT’s showed an excellent correlation with conventional microscopy. Conclusion: Malaria (P. vivax) is a persistent problem in the Malwa region with variation in its transmission dynamics with in the year. P. vivax is the main species of malarial parasite in the Faridkot district with occasional cases of falciparum malaria. Prevention strategy should be targeted towards on the spot diagnosis by using RDT and hence prompt treatment. It could help to prevent spread of drug resistance and complicated malaria.

Introduction: Historically, countless compounds in aqueous solution have been suggested as root canal irrigants. MTAD shows promise as an endodontic irrigant but there are very few studies comparing its antimicrobial effectiveness with NaOCl and Chlorhexidine. Objectives: To compare the antibacterial efficiency of MTAD, 2.5% Sodium Hypochlorite and 2% Chlorhexidine root canal irrigants against Enterococcus faecalis in root canals of single rooted mandibular premolars. Method: Inoculum of 10 μl, 24hrs pure culture Enterococcus faecalis was suspended into root canals of forty extracted, decoronated, double sterilized, human mandibular single rooted premolar teeth and incubated for 48hrs at 37°C. Teeth were randomly divided into 4 groups of 10 teeth in each group. The teeth were instrumented in step back technique till size 40 K- file and irrigated with respective root canal irrigants as per the groups. In Group A- MTAD, Group B- 2.5% NaOCl, Group C- 2% Chlorhexidine and Group D- normal saline was used. Bacterial sample from each tooth was collected and bacterial culture was carried out using standard Loop technique. Inoculated plates were incubated at 37°C for 48hrs. Bacterial colonies were counted using colony counter. Statistically Analysed: Using One way ANOVA and LSD Post Hoc test. Results: There was a statistically significant difference in the antibacterial efficiency between all the groups. Conclusion: Within limitations of this study it can be inferred that MTAD has best antibacterial efficiency against Enterococcus faecalis when compared to 2.5% Sodium Hypochlorite and 2% Chlorhexidine.

To determine the current prevalence of four major sexually transmitted infections (STIs: HIV, Hepatitis B, Herpes simplex virus 2, and Syphilis) in asymptomatic pregnant women.This is a prospective study of 500 consecutive, apparently healthy asymptomatic pregnant women who were attending the antenatal clinic. The information regarding their socio-demographic and behavioral characteristics and obstetric performance was recorded. The blood samples was collected after obtaining their informed written consent from those who were tested for the HIV antibodies (NACO guidelines), HBsAg (ELISA test), HSV2-IgM (ELISA test), and Syphilis (VDRL and TPHA tests).The overall prevalence of one or the other four STIs studied was 4.8 % with the highest prevalence of HBV (2.4 %), followed by HSV-2 (2 %), and HIV (0.4 %). No woman tested positive for syphilis and multiple infections. All the infections were more common in illiterate, multigravida, monogamous women of low socio-economic status. High-risk sexual behavior of the husbands, history of STIs in husbands, and blood transfusions were the other factors associated with the prevalence of these infections.The relatively high prevalence of HBV and HSV-2 infections in asymptomatic pregnant women suggests that there is need of screening for HBV and HSV-2 infections along with the pre-existing screening for HIV and Syphilis and universal immunization of HBV high-risk infants.

Background and Aims: Skin and mucocutaneous disorders are common in HIV infection and may be the earliest manifestation of the disease. The spectrum of these disorders is wide and may vary in different regions due to varying prevalence of various microbial agents. Therefore, we studied the seroprevalence of HIV infection in patients presenting with skin and mucocutaneous disorders and clinical and regional epidemiological profile of seropositive patients. Methods: Eleven hundred and seventy patients having any type of skin or mucocutaneous disorders were screened for HIV infection (NACO guidelines) after recording their clinical and epidemiological profile. Results: Of the 1170 patients screened, 38 (3.24%) were found to be positive for HIV 1 and none for HIV 2 antibodies. Seropositive patients belonged to the age group of 9 to 48 years, with a male:female ratio of 0.9:1. Heterosexuality was the most common mode of transmission (86.8%). A wide range of infectious and noninfectious lesions were observed and herpes zoster was the most common infectious disease (31.5%) followed by mucocutaneous candidiasis (26.3%). The most common noninfectious manifestation was seborrhoeic dermatitis (18.4%) followed by pruritic papular eruptions (7.9%). Conclusion: High prevalence and wide variety of skin and mucocutaneous disorders in HIV-positive patients highlight the importance of better vigilance and early suspicion of HIV infection in such patients.

Introduction: The number of fungal infections caused by uncommon fungi has increased in recent years. Cyberlindnera fabianii is a yeast species that is a rare cause of human infections. In previous cases, isolation of Cyberlindnera fabianii has been reported only from blood specimens and only infrequently. This report describes what we believe is the first case of isolation of Cyberlindnera fabianii from a urine specimen of an immunocompromised 5-year-old child who had a history of prolonged hospitalization and exposure to multiple antibacterial agents and who was neutropenic. Case presentation: A 5-year-old male child presented in paediatric emergency in a febrile (103 °F), conscious but confused and irritable state. A number of risk factors were present in the child including an immunocompromised state, prolonged prior hospitalization, exposure to multiple antibiotics, indwelling catheters and neutropenia. A urine culture showed pure and significant growth of Candida sp., which was identified as Candida utilis (resistant to amphotericin B) by Vitek 2 Compact (bioMerieux). Subsequent 26S rRNA gene sequencing identified it as Cyberlindnera fabianii. Conclusion: Molecular assays have a major role in confirming the identity of uncommon fungal isolates, as correct identification is important for epidemiological purposes. It is imperative that antifungal susceptibility should be performed along with identification of the Candida sp.

The study was carried out to investigate the prevalence, risk factors, and Pregnancy outcome in anti-HCV-positives pregnant women admitted for delivery in the Department of Obstetrics & Gynecology of Guru Gobind Singh Medical College and Hospital, Faridkot between January 2010 and January 2013. Department of obstetrics and Gynaecology of GGS Medical College and Hospital, Faridkot. A case–control study design was selected for the study. A total of 1412 pregnant women presenting in the labor room of our hospital between January 2010 and January 2013 were subjected to anti-HCV testing by third generation ELISA. Age, parity, and gestational age-matched controls were taken from the women delivering during the same time frame who tested negative for hepatitis C. All the subjects and controls were non-reactive for HIV and HBsAg as well. Risk factors and pregnancy outcome were compared with the control group. Approval was taken from ethic committee of the institute. The women who consented to participate in the study were evaluated on the basis of a questionnaire for the presence of risk factors of hepatitis C and pregnancy outcome. Women with the known previous liver disease were excluded from the study. Data were analyzed using SPSS for Windows version 16.0. p

Reproductive tract infections (RTIs) including sexually transmitted infections (STIs) are recognized as public health problem and rank second as the cause of healthy life lost among women of reproductive age after maternal morbidity and mortality in developing countries.(1) Emerging epidemics of Acquired immunodeficiency syndrome (AIDS) and identification of STIs as a co-factor in its acquisition have made the control of these infections, one of the strategies imperative to decrease the transmission of HIV/AIDS. World over 340 million people are affected by STIs, out of which 30 million reside in India.(1) However baseline information on STI prevalence in India especially in general population which is necessary to formulate control strategies is lacking. Therefore the present community based study was carried out to determine the current prevalence rates of RTIs/STIs (HIV infection, genital herpes, syphilis, chlamydial infection, gonorrhea, trichomoniasis, candidiasis and bacterial vaginosis) in a rural setup.

Three hundred and forty serum samples collected from women of child bearing age, without any clinical evidence of cytomegalovirus (CMV) infection, were screened for the presence of IgG antibodies against CMV by ELISA test. The IgG antibodies were detected in 297 which gave prevalence rate of 87.4%. Significantly higher prevalence rates (p < 0.001) were observed with increasing age and with increase in parity. There was significant difference in the antibody prevalence in different socioeconomic groups. Seroprevalence rate was also found to be more in women from rural area than those from urban area, although the difference was statistically not significant (p > 0.05). Marital status showed no impact upon the seroprevalence of IgG antibodies in women.

Ear discharge specimens from 182 clinically diagnosed cases of chronic suppurative otitis media were cultured for isolation of fungi and bacteria. Positive fungal cultures were obtained in 13.7 %; present alone in 7.6% and incombination with various bacteria in 6.1%. Bacteria alone were present in 60.4% cases. The fungal isolates were candida albicans (60%) and Aspergillus (40%). Bacterial isolates showed the predominence of pseudomonas aeriginosa (44.8%) followed by Staphylococcus aureus (20.4%). Newer antibiotics like Cefotaxime, Gentamicin and Ciprofloxacin were found to be more effective against all the gram positive and negative isolates.

Sir, Methicillin resistant Staphylococcus aureus (MRSA) has emerged as a dangerous pathogen of hospital acquired infection and is also spreading in the community1,2. We report here data on this infection from a teaching hospital located in North-West India. During 2012-2013, a total of 248 Staphylococcus aureus isolates obtained from various clinical specimens like pus, blood, urine, body fluids, catheter tips etc. Of the patients visiting Guru Gobind Singh Medical College (GGSMC) and Hospital, Faridkot, Punjab, India, were studied. Of these, 161 (64.9%) were detected as MRSA and 87 (35%) as methicillin sensitive Staphylococcus aureus (MSSA) by observing their resistance to cefoxitin (30 µg) disc3. Further confirmation of methicillin resistance was done by demonstration of mecA gene by PCR4. Overall, MRSA was found in 64.9 per cent (161/248) samples which was higher than the prevalence reported in Indian Network of Surveillance of Antimicrobial Resistance (INSAR) study (41%)1 but was in the range (22 to 68%) observed by various centres participated in the study1. The MRSA increased from 60.5 per cent (92/152) in 2012 to 71.8 per cent (69/96) in 2013, but the difference was not significant. Similar increase has also been reported by six of the 15 tertiary care centres during the two years period (January 2008 to December 2009) of the surveillance1. In our study, the isolation rates of MRSA from non-ICU inpatients (50% in 2012; 69.6% in 2013) were higher than that of outpatients (29.3% in 2012; 18.8% in 2013) and ICU patients (20.7% in 2012; 13% in 2013). This was in contrast to the INSAR study where the isolation rates of MRSA were maximum from ICU followed by non-ICU inpatients and outpatients1. The study of S. aureus isolates from various clinical specimens at our centre showed that maximum isolates were from skin and soft tissue infections followed by blood stream infections and respiratory infections. Susceptibility to various antibiotics is shown in the Table. Similar to the various studies of the INSAR surveillance1, we observed that MRSA isolates were more resistant to antimicrobial agents in comparison to MSSA. However, this difference was not significant for erythromycin, clindamycin, gentamicin and ciprofloxacin. However, for ampicillin and co-trimoxazole the difference was found to be significant (P

A total of 14555 serum samples collected between January, 2001 to April, 2006 were screened for HIV infection. Antibodies to HIV-1/ HIV-2 were present in 985 (6.76%) of which 964 (97.86%) and 2 (0.22%) were positive for HIV-1 and HIV-2 alone respectively and 19 (1.92 %) for both HIV-1 and HIV-2. Of the 21 in whom HIV-2 infection was detected (alone and dual), 19 (90.5%) were in the age group of 21-40 years and 2 were children below the age of 11 years. Predominantly mode of transmission in them was heterosexual (85.71%) while the 2 children (9.53%) had most probably got the infection through perinatal route. Nine (42.85%) were asymptomatic and 12 (57.15%) clinically presented with chronic diarrhoea (5), prolonged fever (4) and symptoms related to sexually transmitted diseases (3). Opportunistic infections like Oral candidiasis was observed in 3 and pulmonary tuberculosis in 2.

Three groups of populations at high risk of human immunodeficiency virus (HIV) infection, i.e., injecting drug users (IDUs), truckers, and attendees of sexually transmitted disease (STD) clinic of Amritsar (Punjab), Northern India, were studied in order to determine the prevalence of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) infections. Of the 157 IDUs, 16.6, 17.8, and 33.7% were found to be positive for HIV, HBV, and HCV infections, respectively. HCV showed significant difference (P0.01) and very high rate (8.3%) of co-infection with HIV. In truckers, maximum seropositivity was associated with HIV (19%), i.e., significantly higher than that of HBV (6%, P0.01) and HCV (3%, P0.01). In STD clinic attendees, the highest rate of seroprevalence was that of HIV (4.3%), followed closely by that of HBV (3.7%), and HCV (2.6%). The present study emphasizes the need for early screening for HBV and HCV infections of all those also at high risk for HIV infection, and the results highlight the importance of relevant targeted interventions in these populations.

A total of 580 females (200 in prepubertal age and 380 in reproductive age group) were screened for primary rubella infection. Rubella specific serology (IgM and IgG) was studied by ELISA using commercially available diagnostic kits. IgM seropositivity was observed in 56 of 200 females (28%) of prepubertal age and 26 of 380 females (6.84%) in reproductive age group. Out of 380 females in reproductive age, 183 presented with history of adverse pregnancy outcome and they showed a higher percentage of IgM seropositivity (10.38%) as compared to those with normal obstetric performance (3.55%). However, the difference was not statistically significant (p0.05). IgG seronegativity was found in 109 females (28.68%) in reproductive age suggesting their susceptibility to acquire primary rubella infection. Five of 380 (0.32%) females were seropositive for both IgG and IgM indicating reinfection.