Fatal Klebsiella pneumoniae meningitis in a patient with diabetes mellitus and Hansen's disease.

Klebsiella is a Gram-negative bacterium that causes different types of health care-associated infections including pneumonia, bloodstream infections, surgical site infections and meningitis. We report here a case of Klebsiella pneumoniae meningitis in a patient with diabetes mellitus and Hansen’s disease. A middleaged man with a known case of diabetes mellitus and Hansen’s disease presented with the complaints of blurred vision in the left eye and the patient was found to have cataract. Patient was operated for cataract and Intraocular lens implanted. Patient developed headache and vomiting on the 4th post-operative day. Lumbar puncture was carried out and gram stain of cerebrospinal fl uid showed Gram-negative bacilli in the direct smear and culture yielded a heavy growth of K. pneumoniae. The patient was treated with antimicrobials according to the susceptibility pattern. He initially showed improvement but later on developed altered sensorium and hypotension. Patient succumbed to infection in spite of all medical attention.

Comparison of double disc synergy test and phenotypic confirmatory disc diffusion test for detection of ESBL production and their antimicrobial resistance pattern.

Extended spectrum beta- lactamases (ESBLs) continue to be a major problem in clinical setup worldwide. An attempt is made to detect ESBL production among Enterobacteriaceae members by phenotypic methods, which is easier to perform in all laboratories. A total of 138 multi-drug resistant strains from pyogenic infection were tested for ESBL production by Double disc synergy test (DDST) and Phenotypic confirmatory disc diffusion test (PCDDT). Of the 84 ESBL producer identified, PCDDT detects 71 (84.5%) whereas DDST detects 52 (61.9%) as ESBL producers. Continued detection of ESBL is essential for proper disease management. PCDDT is better and easy test for screening than DDST. Confirmation has to be done by molecular methods.