ABSTRACT
Streptococcus pneumoniae is a major pathogen of humans, causing diseases such as pneumonia,bacteremia and meningitis. The authors report a case of pneumococcal septicemia with meningitis in an infant. The objective of reporting this case is to highlight the importance of blood culture for early diagnosis. Alertness and rapid diagnosis led to favorable outcome in our case.
ABSTRACT
Aim: To isolate, identify and characterize the prevalence of non- fermenting gram negative bacteria (NFGNB) along with their antimicrobial resistance pattern among the patients attending a tertiary care Hospital in Meerut. Materials and Methods: The isolates of NFGNB obtained from various samples were identified by standard bacteriological technique and VITEK® 2 system (Biomerieux , France) . Antimicrobial susceptibility test was carried out to assess the resistance profile both by Kirby Baeur disk diffusion method and VITEK® 2 system (Biomerieux , France) . Result: Atotal of 16,296 clinical samples from the indoor and outdoor patients were processed in the bacteriology laboratory. Isolation rate of nonfermenters was 7.82% (1274/16296). Pseudomonas spp. was the predominant isolate (66.56%) followed by Acinetobacter spp. (27.16%). Other isolated non-fermenters were Burkholderia cepacia complex (BCC)(1.57%), Stenotrophomonas maltophila (0.86%), Sphingomona spaucimobilis (0.71%), Achromobacter xylosoxidans (0.16%), Ochrobactrum anthropic (0.16%). Conclusion: NFGNB are emerging as important opportunistic pathogens and are mostly resistant to commonly used antimicrobials. Therefore early diagnosis and initiation of appropriate antibiotic therapy would help in efficient management of patients and result in reduction of morbidity and mortality caused by these multi drug resistant organisms.
ABSTRACT
Context: Carbapenemase production is an important mechanism responsible for carbapenem resistance. Aims: Phenotypic detection and differentiation of types of carbapenemase in carbapenem resistant Enterobacteriaceae is important for proper infection control and appropriate patient management. Settings and Design: We planned a study to determine the occurrence of Class A Klebsiella pneumoniae carbapenemase (KPC type) and Class B Metallo-β-lactamase (MBL type) carbapenemase in hospital and community. Materials and Methods: Clinical isolates of Escherichia coli and Klebsiella species and simultaneously evaluate different phenotypic methods for detection of carbapenemases. Results: It was observed that 20.72% clinical isolates of E. coli and Klebsiella spp. were resistant to carbapenem on screening of which, 14.64% were E. coli and 29.69% were Klebsiella spp. Using phenotypic confirmatory tests the occurrence of carbapenemase production was found to be 87.01% in E. coli and 91.51% in Klebsiella spp. using both modified Hodge test (MHT) and combined disk test (CDT) using imipenem-ethylenediaminetetraacetic acid. Conclusions: Both MBL and KPC type carbapenemases were seen among clinical isolates of E. coli and Klebsiella spp. CDT is simple, rapid and technically less demanding procedure, which can be used in all clinical laboratories. Supplementing MHT with CDT is reliable phenotypic tests to identify the class A and class B carbapenemase producers.