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Objectives: Chryseobacterium indologenes has recently been identified as an inherently drug-resistant organism, responsible for a wide spectrum of infections, mainly device-associated infections in hospital settings. The presence of carbapenem resistance due to blaNDM-1 metallo-?-lactamase (MBL) gene further complicates the matter, leading to widespread dissemination of carbapenem resistance. This study aims to find out the presence of blaNDM-1 gene among C. indologenes strains causing bloodstream infections in a tertiary care hospital. Materials and methods: During 1 year of the study period, blood culture samples were collected from patients with features of bacteremia, and C. indologenes strains were isolated and identified as per protocol. Antibiotic sensitivity test was performed by using VITEK 2 Compact Automated AST machine (Biomerieux, France). Carbapenem-resistant strains were subjected to a combined disk diffusion test for detecting the presence of MBL enzyme. Strains positive for MBL production were subjected to a polymerase chain reaction (PCR) for detection of blaNDM-1 gene. Results: Out of 21 strains isolated during the study period, 12 strains (57.1%) were carbapenem-resistant. Among them, seven strains (58.3%) were MBL producers. After PCR, 3 strains (42.9%) were found to be harboring blaNDM-1 gene Discussion: As per our knowledge, this is the first report of blaNDM-1 gene harboring C. indologenes strain from Northeast India. This shows the emerging therapeutic dilemma due to the narrowing of treatment options against bloodstream infections due to C. indologenes strains. Strict antimicrobial stewardship has to be implemented to prevent the further compounding of the problem.
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One of the major causes of morbidity and mortality in tropical and subtropical regions is Dengue viral infection. This virus belongs to family flaviviridae comprising of four antigenically distinct serotypes DENV 1 - 4. A small number of studies conducted in North Eastern (NE) Region of India reported Dengue cases in Assam, Meghalaya, Nagaland, Manipur and Arunachal Pradesh. However, no studies have been conducted in the state of Tripura, with regard to pattern of Dengue viral infection and its circulating serotypes. Therefore, this study was undertaken to identify the serotypes circulating in Tripura. MethodsPatients with acute febrile illness were tested for detecting Dengue viral infection by MAC ELISA and / or NS1 detection test at Viral Research and Diagnostic Laboratory (VRDL), of a tertiary care centre in Tripura for a period of 3 years. All NS1 positive samples were further tested for presence of viral RNA by Reverse Transcriptase –PCR (RT - PCR) and serotyping was done using serotype specific primers. ResultsA total of 2515 acute febrile cases seen over a period of 3 years from 2014 to 2017 was tested for Dengue virus infection by serology. Out of 2515 of cases, 405 cases tested for NS1 antigen, where 10.61 % (43 / 405) was NS1 positive. The remaining 2110 cases were tested for IgM antibody MAC ELISA and 15.68 % (331 / 2110) was MAC ELISA positive. Out of all NS1 antigen positive cases 34.88 % of PCR positive and serotype characterisation showed DENV - 1 was predominant serotype followed by DENV - 2 and DENV - 4 respectively. ConclusionsThere is a rising trend of Dengue virus infection in Tripura with circulation of multiple serotypes. Moreover, cocirculation of multiple serotypes is a risk to the emergence of recombinant strains and also heterotypic infection in the near future might lead to development of DHF and DSS. Hence, molecular characterization of circulating serotypes may be helpful in addressing the probabilities of Dengue outbreak and possibilities of complications.