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Faecal carriage of Carbapenem-resistant Enterobacteriaceae (CRE) is being observed as an important risk factor for bacteremia among patients with hematological malignancies. A prospective surveillance study was conducted among these patients to determine the gut colonization of CRE. Rectal/perianal swabs were collected to isolate CRE. Carbapenem resistance was detected by disk diffusion, modified-Hodge, Carba-NP test, and PCR for blaNDM-1, blaKPC, blaOXA-48, blaVIM, blaIMP genes. A total of 209 CRE isolates were identified from 151 patients. E. coli was the most common (83.2%) CRE identified, followed by Klebsiella spp. (9.6%). The majority of CRE were observed resistant to ertapenem (86%). blaNDM-1 was the most common gene (57.3%), followed by blaOXA-48 (37.8%). 26.8% isolates found to carry both blaNDM-1 and blaOXA-48 genes. CRE is increasingly observed to cause bacteremia among hematological malignancy patients due to increased colonization. Screening for gut CRE colonization is necessary to guide empirical therapy and apply infection control measures among these patients.

Urinary tract infections are one of the most common bacterial infections causing high morbidity and mortality. Alarming rise of multidrug resistant uropathogens worldwide, forced the clinician to rethink about the old drugs like Fosfomycin for its therapeutic management. Our objective was to compare agar dilution (AD), disc diffusion (DD) and E test method for antimicrobial susceptibility testing (AST) of Fosfomycin against different drug resistant uropathogens. Consecutive 181 uropathogens were tested for Fosphomycin AST using AD, DD and E test. Results were interpreted using Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints. Escherichia coli was found as the most common (62.4%) uropathogen followed by Klebsiella spp. (21%). Considering agar dilution as gold standard, 6.1% of isolates were resistant to Fosfomycin. Following CLSI breakpoints, the susceptibility of E.coli, Klebsiella spp., other Enterobacterales and Pseudomonas aeruginosa were 92.9%, 92.1%, 100 %, 100%; whereas using EUCAST breakpoints the susceptibility rates were 85.7%, 86.9%, 92.9%, and 100%, respectively. The essential agreement, categorical agreement, major error, and very major error for E-test/ DD for all the organisms were 91.2%/Not Applicable, 95%/93.9%, 1.8%/4.7%, 9.1%/9.1%, respectively. This result supports very low resistance of Enterobacterales against Fosfomycin; hence should be considered as a valuable option to treat multidrug resistant uropathogens. DD observed to be a convenient method for Fosphomycin AST comparing AD.

Increasing occurrence of infections caused by multidrug-resistant Gram-negative bacteria resulted in colistin being the last agent for treatment. Apart from plasmid-mediatedA total of 100 carbapenem-resistantAmong 100 carbapenem-resistantThe performance of cBMD was excellent, whereas the E-test was unacceptable. VITEK-2 and RPNP performed better but remained unreliable due to high error rates. Multiple mutations in the target proteins involving lipopolysaccharide formation, modification, and regulation were seen, resulting in colistin resistance.

Prompt and accurate diagnosis of acute bacterial meningitis (ABM) is critical for patient management. We designed and evaluated two sets of multiplex-PCR assays for the simultaneous detection of six major etiologies of ABM i.e.,A total of 113 CSF specimens from patients of all ages having clinical features suggestive of meningitis were tested for bacteriological evidence by Gram's smear, culture, and our designed multiplex-PCR.Multiplex-PCR assay performed excellently by increasing the overall detection rate by 6% when compared to culture as of total 113 samples tested, 17 (15%) were positive by multiplex-PCR whereas only 9% (10/113) were positive by culture. It detected the DNA in eight culture negative samples revealing the presence ofThis study accentuates the importance of multiplex-PCR assay that is efficiently fast and reliable for the diagnosis of acute bacterial meningitis that can substantially improve the diagnosis in culture negative cases, especially in patients who were previously started on antimicrobial therapy.

Faecal carriage of Carbapenem-resistant Enterobacteriaceae (CRE) is being observed as an important risk factor for bacteremia among patients with hematological malignancies. A prospective surveillance study was conducted among these patients to determine the gut colonization of CRE. Rectal/perianal swabs were collected to isolate CRE. Carbapenem resistance was detected by disk diffusion, modified-Hodge, Carba-NP test, and PCR for (bla)NDM-1, (bla)KPC, (bla)OXA-48, (bla)VIM, (bla)IMP genes. A total of 209 CRE isolates were identified from 151 patients. E. coli was the most common (83.2%) CRE identified, followed by Klebsiella spp. (9.6%). The majority of CRE were observed resistant to ertapenem (86%). (bla)NDM-1 was the most common gene (57.3%), followed by (bla)OXA-48 (37.8%). 26.8% isolates found to carry both (bla)NDM-1 and (bla)OXA-48 genes. CRE is increasingly observed to cause bacteremia among hematological malignancy patients due to increased colonization. Screening for gut CRE colonization is necessary to guide empirical therapy and apply infection control measures among these patients.

Introduction: Detection of carbapenem resistance in the clinical microbiology laboratory is challenging. Production of carbapenemase enzymes remains the most important mechanism among Carbapenem Resistant Enterobacteriaceae (CRE). Ertapenem has been found as a sensitive marker for detecting CRE, especially the non-carbapenemase producing CRE. However, limited literature is available discussing its specificity and sensitivity in comparison to gold standard tests. Aim: To compare the ability of the ertapenem disc diffusion test with other confirmatory tests i.e., Epsilometer test (E test), Carbapenemase Nordmann-Poirel (CNP) test, and Polymerase Chain Reaction (PCR) for CRE identification. Materials and Methods: Seventy six phenotypically confirmed Enterobacteriaceae isolates were tested for carbapenem resistance. Ertapenem susceptibility was compared with imipenem, meropenem, and doripenem disc individually and in combination to determine its sensitivity. Further, it was compared with the E test, CNP test, and PCR to find the concordance of the result. Data were analysed by statistical software using Chi-square test with p-value

Measurement of human vertebral geometry is important for accurate surgical procedures. The aim of this study is to measure the neural ach shape from L1 to L5. All Lumbar dry vertebrae (N = 150) of 30 individuals is measured and analyzed by gender. A Digital Vernier Caliper is used to measure the dimensions of the spinous (SP) and transverse (TP) processes, vertebral canal (VC), laminae, and isthmus. Most of the parameters are greater in males. Isthmus length decreases from L1 to L5 vertebrae in males with left side length greater than that of right in the lumbar region. In lumbar vertebrae transverse process length is increasing from L1 (17.83 mm) to L3 (22.58 mm) then decreasing till L5 (18.70 mm) with right side length more than the left side at L1 to L5. Vertebral Superior Canal Width (VSCW) is increasing more than Vertebral Superior Canal length (VSCL) in lumbar vertebrae. The difference of width and length is increasing from L1 (5.65 mm) to L5 (9.28 mm). The shape of vertebral canal is oval in lumbar vertebrae. In conclusion, the neural arch is systematically asymmetrical and dynamic in shape along the lumbar spine.

CD38 on CD8 + T cells is considered a reliable marker of HIV disease progression. Withania somnifer, a traditional ayurvedic medicine, has Th1 immunomodulatory properties. PBMCs from 38 HIV patients were exposed to Withania somnifer root extract at standardized concentration. An overall decline in the percentage of CD38 expressing CD8 + T lymphocytes was observed, though the statistical significance was varied with different categories of HIV patients. Withania somnifer could have promising impact on HIV disease and therefore warrants a further study on larger parameters.

BACKGROUND: The prevalence of carbapenem‐resistant Enterobacteriaceae (CRE) is alarming worldwide causing serious infections. Rapid and accurate identification of CRE is crucial to reduce the mortality and morbidity. In this study, we tried to develop an in‐house Carba NP test for detection of CRE and evaluate its performance with others. METHODS: A prospective study was conducted with 40 nonrepeating Enterobacteriaceae isolates over a period of 3 months. All the isolates were screened for carbapenem resistance as per CLSI 2016 guidelines followed by PCR for blaNDM‐1, blaOXA‐48, blaKPC, blaVIM, and blaIMP genes. All the isolates were subjected to five phenotypic tests, that is, in‐house Carba NP (iCarba NP), commercial Carba NP (cCarba NP), Blue‐Carba, modified Hodge test (MHT), and CHROMagar. RESULTS: Among the 40 isolates, 87.5% were identified as Escherichia coli, 7.5% were Klebsiella pneumoniae, 2.5% were Enterobacter cloacae, and 2.5% were Citrobacter freundii. Thirty‐three of 40 (82.5%) isolates were found to harbor one or more resistant genes. Considering PCR to be the gold standard test, sensitivity of the phenotypic methods for CRE detection ranged from 63.6% (MHT) to 96.9% (CHROMagar). Both cCarba NP and iCarba NP observed to have highest specificity. The performance of iCarba NP was found comparable with cCarba NP by kappa score 1 and found approximately 10 times less expensive than cCarba NP. CONCLUSION: CHROMagar was observed most sensitive assay for detection of CRE followed by both Carba NP tests. iCarba NP was proved cheaper and equally good as cCarba NP for detection of CRE.