Clinicomicrobiological profile of podiatric infections: a prospective, cross-sectional study.

INTRODUCTION: Podiatric infections are common in patients with and without diabetes. Biofilm detection would aid in determining the severity of foot infections and preventive strategies to manage them. OBJECTIVE: The authors studied the clinicomicrobiological profile of podiatric infections. MATERIALS AND METHODS: Organisms from podiatric specimens were identified and the antibiotic susceptibility of the organisms determined using standard microbiological methods. Organisms were screened for biofilm production using the microtiter plate method. Staphylococcus aureus isolates were screened for ica, cna, and hlg genes by multiplex PCR. RESULTS: A total of 117 patients were included in the study, and specimens from 71 patients were culture positive (60.6%). Gram-negative bacteria were predominant (n = 88 [73.3%]). S aureus (n = 32 [26.7%]) was the most common isolate. The rate of biofilm production was 54.2%. Pseudomonas aeruginosa was the most prevalent biofilm producer (82.8%). The study revealed a statistically significant association of biofilm formation with MDR, MRSA, and prior antibiotic therapy with multiple (≥4) antibiotics. CONCLUSION: Isolation of MRSA or MDR strain from diabetic foot infections could alert the clinician to the possibility of treatment failure with a single drug regimen owing to associated biofilm production. Detection of biofilm producers and subsequent early debridement and/or cleaning of wounds might prevent chronic infection.

Molecular diagnosis of bacterial and viral diarrhoea using multiplex-PCR assays: An observational prospective study among paediatric patients from India.

PURPOSE: In developing countries, the aetiology of diarrhoea goes undiagnosed as only microscopy, stool culture or enzyme immunoassay are done to find the causative agent. The present study aims to detect common paediatric viral and bacterial diarrhoea pathogens by microscopy, stool culture for bacteria, and multiplex polymerase chain reaction (mPCR) for bacteria and virus detections. MATERIALS AND METHODS: Diarrheal stool samples (n â€‹= â€‹109) received at the laboratory from paediatric patients aged one month to 18 years were included in the study. They were cultured for common bacterial pathogens and simultaneously subjected to two multiplex PCRs one for the detection of Salmonella spp., Shigella spp., Enteroinvasive E.coli and Enteropathogenic E.coli, another for the detection of adenovirus, astrovirus, rotavirus and norovirus. RESULTS: Of the 109 samples cultured for bacterial aetiology, 0.9% (1/109) grew Salmonella enterica ser.Typhi and 2% (2/109) Shigella flexneri. By mPCR, 16% of samples (17/109) were positive for Shigella spp., 0.9% (1/109) for Salmonella spp., and 21% (23/109) for rotavirus. One sample (0.9%) had rotavirus and Shigella spp., which indicates mixed aetiology. CONCLUSIONS: Shigella spp. and rotavirus are the prime causative agents of childhood diarrhoea in our region. The rate of detection of bacterial aetiology by culture was poor. Isolation of pathogens by conventional culture helps to know the species, serotypes and antibiotic susceptibility of the pathogens. Virus isolation is cumbersome, time-consuming, and not available for routine diagnostic use. Therefore, real-time mPCR would be a better choice for early detection of pathogens, thereby ensuring timely diagnosis, treatment, and a reduction in mortality.

Characterization of virulence factors and antibiotic resistance pattern of uropathogenic Escherichia coli strains in a tertiary care center.

Background: Urinary tract infections (UTI) are the most prevalent bacterial infection in humans. The uropathogenic E. coli (UPEC) expresses a range of virulence factors that contribute to their pathogenicity . The emergence of multidrug resistance (MDR)-associated UTI is increasing. This study monitors the distribution of virulence factors among UPEC strains to note the antibiogram, outcome and type of associated UTI. Methods: A prospective cross-sectional time-bound study of six months was done on clinically significant urinary isolates of Escherichia coli. Detection of haemolysin production and serum resistance was done by phenotypic methods. Genotypic characterization of the virulence genes ( papC, iutA, hlyA, cnf1) was done by multiplex PCR. Demographic data, clinical history, antibiogram and type of UTI was collected from clinical case records. Results:75 E.coli isolates from patients with suspected UTIs were included. Females had a higher preponderance of UTI (66.7%). 93% of patients were adults and the remaining 7% were from paediatrics.  24 (32%) isolates showed haemolysis by plate haemolysis and all isolates were serum-resistant. Out of 75 isolates, 65 were positive for at least one of four targeted genes, while remaining ten isolates were negative for all four genes. Multidrug resistance was found in 40 (53.3%) isolates. 97.4% of the UTI cases had a favourable clinical outcome at discharge. Mortality due to urosepsis was 2.6%. Conclusion: Association of hemolysin production with resistance to imipenem and norfloxacin in UPEC strains was significant. Presence of hlyA gene is positively associated with ceftazidime resistance. Nitrofurantoin, piperacillin, tazobactam, and cefaperazone sulbactam are possible candidates for empirical therapy of UTIs. Drugs like aminoglycosides, carbapenems and fosfomycin may be used as reserve drugs in the treatment of MDR-UTI. However, inappropriate usage can increase antibiotic resistance. Hence proper selection of antibiotics in hospitals taking into account the local antibiogram is needed to reduce the emergence of antibiotic resistance.

Profile of Secondary Bacterial and Fungal Infections in Hospitalized COVID-19 Patients in a Tertiary Care Centre.

Introduction: SARS CoV-2, a novel corona virus, has emerged in December 2019. The COVID-19 associated mortality is documented in elderly with co morbidities. To have better insight on this issue, the secondary bacterial infections with multi-drug-resistant bacteria in COVID-19 patients need to be studied to evaluate the impact of these infections on the outcome. Aim and objectives: To determine the proportion of secondary infections in COVID-19 patients. To study the spectrum of pathogens and antibiogram of the bacteria isolated from secondary infections in such patients. To evaluate the co-existing co-morbidities, treatment and outcome in these patients. Methodology: The retrospective study was conducted in Departments of Medicine and Microbiology, KMC hospitals Attavara and Ambedkar circle, Mangaluru, including all the hospitalized microbiologically confirmed cases of SARS CoV-2 infection. Details pertaining to the study population were collected using a structured proforma. Descriptive data were entered in the form of mean, median and proportions. The categorical values were analyzed using Chi square test. Values of p < 0.05 were considered as statistically significant. Results: Two hundred COVID-19 hospitalized patients were included.28 out of 200 patients (14%) studied developed secondary infections. The types of secondary infections were Respiratory infections (50%), blood stream infections (17%), UTI (14%), Rhinocerebral Zygomycosis (17%). The predominant organisms were Klebsiella pneumoniae (44%), Zygomycetes (17%). The rates of antibiotic resistance in Gram negative bacilli were 33% to Cefuroxime,25% to aminoglycosides and fluoroquinolones and 16% to carbapenems. The mortality of 42.8% was observed in patients with secondary infections. Conclusion: Close monitoring and follow up especially in high-risk group of severe COVID 19 patients is crucial for better management and outcome.

Characterization of Hypervirulent Klebsiella pneumoniae (Hv-Kp): Correlation of Virulence with Antimicrobial Susceptibility.

Introduction: Hypervirulent K. pneumoniae (Hv-Kp) is an emerging variant of classical K. pneumoniae (C-Kp) that exhibits hypermucoviscocity and possesses multiple siderophores as virulence factors and is known to cause serious debilitating infections in immunocompetent individuals. Aim and objective. The aim of this study is to identify C-Kp and Hv-Kp strains and detect their virulence factors and antimicrobial susceptibility patterns. Materials and Methods: A total of 129 K. pneumoniae isolates from different clinical samples were used for the identification and differentiation of classical K. pneumoniae (C-Kp) and hypervirulent K. pneumoniae (Hv-Kp) to correlate their virulence with antimicrobial susceptibility patterns and identify their risk factors. Hypermucoviscosity was determined by a string test (>5 mm of string length). The aerobactin gene was detected by PCR. Results and Conclusion. In total, 13.9% (18/129) were Hv-Kp and 86.1% (111/129) were C-Kp. Only 50% (9/18) of the Hv-Kp isolates were hypermucoviscous. C-Kp was significantly more resistant to antimicrobials than Hv-Kp. Among C-Kp, 75.7% were ESBL producers and 76.6% were multidrug resistant while in Hv-Kp, 44.44% were both ESBL producers and multidrug-resistant which is statistically significant (P < 0.01). Diabetes was a common risk factor for C-Kp infections whereas, respiratory disorders like COPD and prolonged ICU stay were the risk factors for Hv-Kp infections. The mortality rate among patients with Hv-Kp infections (87.5%) was significantly high when compared to that of C-Kp infections (35.7%) (P < 0.001). A majority of hypermucoviscous K. pneumoniae isolates were multidrug resistant (65.2%). Although the prevalence of Hv-Kp infections was low, a high percentage of them were multidrug resistant with a significantly high mortality rate. Hence, it is important to efficiently identify Hv-Kp strains from clinical samples and determine their antimicrobial susceptibility patterns, so as to provide immediate and effective treatment and to prevent possible outbreaks.

Genotypic and Phenotypic Expression of Antibiotic Resistance Patterns of Uropathogenic Enterobacteriaceae.

Aim: To determine the antibiotic resistance patterns, detection of carbapenemase genes in uropathogenic bacilli belonging to the Enterobacteriaceae family and to correlate it with clinical data. Materials and Methods: Identification and antibiotic sensitivity testing of the uropathogenic Enterobacteriaceae was done by using VITEK2 Compact (C) system. Multiplex PCR was used to detect blaIMP, blaKPC, blaNDM1, blaOXA -48, and blaVIM genes. Results: Out of 1602 urine samples, 417 (26%) showed significant growth, and in these 311 (74.6%) belonged to the Enterobacteriaceae family. Escherichia coli showed a relatively low rate of resistance to nitrofurantoin (17/205; 8.3%), with the majority of the isolates showing a MIC value of ≤16 µg/mL when compared to Klebsiella spp. (55/86; 64%), with MIC values for the majority of isolates being 128 µg/mL. Klebsiella spp. showed a relatively low rate of resistance to nalidixic acid (48/86; 55.8%) when compared with E. coli isolates (179/205; 87.3%). Out of 145 isolates tested, we found blaNDM in 11 (7.58%), bla OXA -48 in 8 (5.51%), bla VIM in 4 (2.75%), bla KPC in one (0.6%) and blaIMP in none of the isolates. Of these 3 isolates were carbapenem sensitive, the rest were resistant. Conclusion: Most of the isolates were sensitive to fosfomycin, carbapenems and resistant to cephalosporins and nalidixic acid. We detected carbapenemase genes in 13 (59%) out of 22 carbapenem resistant isolates and 3 (2.4%) out of 123 carbapenem sensitive isolates.

Fungal infections of spine: Case series during the COVID times.

Fungal infections of the spine are a rare occurrence. We report three cases of Spondylodiscitis due to Aspergillus fumigatus, Candida albicans and Scedosporium apiospermum. Case 1:37 year old male, with history of COVID-19 infection one month prior presented with L1-2 Spondylodiscitis. Tissue showed growth of Aspergillus fumigatus. Case 2:75 year old male was admitted with swelling over low back. Pus aspirated from the swelling and tissue sent from operated site showed growth of Candida albicans. Case 3:56 year old known diabetic and end stage renal disease on hemodialysis presented with mid back pain since 2 months. Culture showed growth of Scedosporium apiospermum.

Detection of SARS-CoV-2 in conjunctival secretion and tears in patients with COVID-19 in a tertiary care centre, South India. .

Aims and objectives: Purpose of this study is to detect the presence of SAR-CoV-2 viral RNA in conjunctival secretions of COVID-19 patients and to compare the RT-PCR positivity rate for SARS-CoV-2 in conjunctival and nasopharyngeal swab. Materials and method: Eighty hospitalised COVID-19 patients whose nasopharyngeal swab tested positive for SARS-CoV-2 by RT-PCR were included in the study. Conjunctival swab was collected from eyes of these patients and sent for detection of SARS-CoV-2 by RT-PCR method. Results: Among the eighty patients, 51 (63.7%) were males and 29 (36.3%) were females. The mean age of the patients was 55.93 ± 16.59. Six patients had ocular manifestations. Eleven (13.75%) patients tested positive on conjunctival swab for SARS-CoV-2 viral RNA and only one of them had ocular manifestations out of the eleven. Conclusion: In our study the presence of SARS-CoV-2 in conjunctival secretions of COVID-19 patients was detected and this was not dependent on presence of ocular manifestations or duration of disease. Though the conjunctival positivity is lower compared to the nasopharyngeal swab sampling, ocular surface and secretions can be a potential route of viral transmission.

Bacterial Infection among Cancer Patients: Analysis of Isolates and Antibiotic Sensitivity Pattern.

INTRODUCTION: Cancer patients being immunosuppressed are vulnerable to develop infections. Knowledge of the changing epidemiology of infections has a pivotal role in its management. Aims and Objectives. The study is undertaken to assess the types of bacterial infections in cancer patients undergoing anticancer treatment, the associated bacterial pathogens, and their antibiotic sensitivity patterns. MATERIALS AND METHODS: A retrospective surveillance study was undertaken in our center. Positive culture reports and other clinical details of cancer patients diagnosed with infection during a stay in the tertiary care center from 1st January 2015 to 31st December 2016 were analysed by descriptive statistical methods chi-square test and odds ratio to study the association. RESULTS: Out of 638 cancer patients diagnosed with infections in the 2-year period, 140 patients had positive cultures, representing 272 specimens and 306 isolates. Common specimens sent for culture were blood sputum, urine, and pus. 214 isolates (69.9%) were gram-negative bacilli, and 92 (30.1%) were gram-positive cocci. The most common isolates were Klebsiella spp. (18.30%), Pseudomonas spp. (17.65%), and Escherichia coli (14.71%) followed by Staphylococcus aureus (13.72%). Among the gram-negative organisms, the antibiotic resistance rates reported to fluoroquinolones, aminoglycosides, and third-generation cephalosporins were 45.13%, 39.20%, and 48.58%, respectively. 26.92% of the organisms are resistant to all three antibiotics. 50.4% of Klebsiella spp. and Escherichia coli were ESBL producers. Gram-negative organisms showed 11.63% resistance to ß-lactam/ß-lactamase inhibitor combination, and 22.22% of gram-negative organisms are resistant to carbapenems. 50% of the Staphylococcus spp. were methicillin resistant, but all were sensitive to vancomycin. CONCLUSION: The surge in the number of gram-negative infections emphasizes the need for broad-spectrum empirical therapy targeting the same. Rate of resistance of the isolated gram-negative organisms to the routinely used empirical therapy is alarming. Prudent use of antibiotics, based on culture reports wherever possible, is of utmost importance to save the lives of infected patients and prevent further development of antibiotic resistance.

Changing antibiotic susceptibility pattern in uropathogenic Escherichia coli over a period of 5 years in a tertiary care center.

Objective: To assess the changing antibiotic sensitivity pattern in Uropathogenic E. coli over a period of time (2013-2017) with a special emphasis on ESBL-producing E. coli. Methods: This retrospective study was carried out in the Department of Microbiology, Kasturba Medical College, Ambedkar Circle, Mangalore. A retrospective time bound analysis of 500 samples/year was performed. The urine samples received from the suspected cases of urinary tract infection (UTI) were processed. Wet mount examinations of urine samples were done. The urine culture was done by a semi-quantitative method on Mac Conkey's agar, Cysteine Lactose Electrolyte Deficient (CLED) medium, and UTI Chrome agar. Culture plates were incubated for 18-24 hours at 37°C. Urine samples with a colony count of ≥105 CFU/ml were considered significant. The uropathogens were identified by their biochemical reactions. The antibiotic susceptibility testing (AST) was carried out using a Vitek Compact 2 system and Modified Kirby Bauer disc diffusion method. Results: Antibiotic resistance of Uropathogenic E.coli to cephalosporins increased from 51 to 58%, Cotrimoxazole: 52 to 59%, Piperacillin tazobactam 9.4 to 23%, Carbapenems 0 to 5.9%. Antibiotic resistance to netilmicin has reduced from 8 to 6.5%, and norfloxacin 59 to 48%. The rates of ESBL production have increased from 45.2 to 59.6% in the 5 years. Conclusion: The increasing antibiotic resistance trends in UTI patients indicate that it is vitally important to use them conservatively. Proper guidelines, management of antibiotic usage, and constant information to the clinicians regarding the sensitivity pattern can help to prevent drug resistance.

A study on biofilm production and antifungal drug resistance among Candida species from vulvovaginal and bloodstream infections.

INTRODUCTION: Candida species, one among the opportunistic fungi, has become a common pathogen causing vaginal thrush and nosocomial bloodstream infections (BSIs). This study aims to evaluate the prevalence and antifungal susceptibility of various Candida species and slime production by Candida species in BSIs and vulvovaginal candidiasis (VVC). MATERIALS AND METHODS: A total of 176 samples were collected for a period of 1 year. Anti-fungal susceptibility testing and biofilm production testing were performed by the Kirby-Bauer method and crystal violet assay, respectively. RESULTS: Out of 176 samples, 74 (42%) were from BSIs and 102 (58%) were from VVC. The biofilm production was comparatively high in blood isolates, 55 (74%), than cervical isolates, 45 (44%). Increase in the trends of non-albicans Candida (NAC) species was seen in our setup. Good susceptibility rates were seen among Candida species, 82.38% to voriconazole and an increasing resistance pattern of 26.13% to fluconazole. CONCLUSION: Speciation of Candida becomes important as the prevalence of NAC is increasing. Antifungal susceptibility testing by the disk diffusion method is cost effective and should be adopted in routine testing as there is an increasing azole resistance, especially in invasive NAC infections. In this study, there was no correlation of antifungal drugs with the biofilm production.

Bacteriological Assessment of Bottled Drinking Water Available at Major Transit Places in Mangalore City of South India.

Introduction: Safe drinking water is essential for human life. It is generally considered that bottled water is safe for usage by people. For long-distance travelers, it serves as the only source of reliable drinking water. But, several studies have reported that bottled water does not always meet the acceptability standards. Objectives: To assess the bacteriological and physical quality of bottled water marketed in major transit areas and to check its compliance with national standards. Methods: The investigating team visited retail shops at three main transit sites for long-distance travelers in Mangalore city. A total of 24 water bottles of 12 brands were randomly selected. The analysis of total viable count (TVC) was done to assess the bacteriological quality of samples. Results: In 3(12.5%) samples, all of which were of local brands, batch number, the period of manufacture, and the period of expiry were not mentioned. Odor and floating bodies were present in one sample each. Five (20.8%) water bottles had been enriched with minerals. Ozone treatment was the most commonly 22(91.7%) used method for disinfection of water. In only 15(62.5%) samples, the bacterial contamination was within acceptable limits certified for drinking purposes. Water samples manufactured by multinational companies (p=0.018), those with batch number mentioned (p=0.042), the best period of manufacture (p=0.036), and long expiry dates (p=0.028) were acceptable for usage. Conclusion: Surveillance of bottled water manufacturing industries in the settings on a regular basis needs to be done by regulatory agencies. These measures will ensure safe and wholesome bottled water for public usage.

Comparison of the Antimicrobial Efficacy of Various Contact Lens Solutions to Inhibit the Growth of Pseudomonas aeruginosa and Staphylococcus aureus.

Soft contact lenses provide perfect conditions for the breeding of pathogens. The study is a prospective, experimental study, conducted to know the antimicrobial ability of multipurpose contact lens solution against standard strains of Staphylococcus aureus and Pseudomonas aeruginosa by the stand-alone test. The test method is based on the procedures in the ISO 14729 standard primary stand-alone test. Three multipurpose contact lens care solutions commercially available in Mangalore markets, namely, Biotrue (Bausch & Lomb), Opti-Free Replenish (Alcon), and Aquasoft (Stericon Pharma), were tested for its antimicrobial effect in the microbiology lab at Kasturba Medical College, Mangalore. According to this study, the solutions named "Biotrue" and "Aquasoft" met the primary stand-alone and reached the 3log reduction and 5log reduction criteria in the manufacturer recommended time, respectively. No conclusion could be drawn for Opti-Free Replenish since the minimum recommended disinfection time was overnight, whereas it was noted for 6 hr only, and it should have been experimented further. The effectiveness of multipurpose solutions varies against different bacterial species. We have observed that the antimicrobial activity of different solutions varies with respect to time of incubation, and also there was a marked difference in the activity of some solutions against S. aureus and P. aeruginosa. So, it is necessary for the contact lens users to store their lenses in solutions for longer duration of hours. It is also recommended to use solutions that clear the ISO 14729 standards for better health conditions of the eye.

Fecal Carriage of Extended-spectrum Beta-lactamase-producing Enterobacteriaceae in Intensive Care Unit Patients.

BACKGROUND AND AIMS: Increasing and indiscriminate use of antibiotics has led the bacteria to develop resistance to most of the antibiotics. Beta-lactamase production is the mechanism of resistance to beta-lactams. Extended-spectrum beta-lactamases (ESBLs) have been found in the members of Enterobacteriaceae such as Escherichia coli and Klebsiella spp. which are the common health-care-associated pathogens. The aim was to study the rate of fecal carriage of ESBL-producing Enterobacteriaceae in patients admitted to the Intensive Care Unit (ICU) of tertiary care hospital and follow them subsequently for the development of infections. MATERIALS AND METHODS: A hospital-based descriptive study was conducted in the department of microbiology of a tertiary care hospital for a period of 2 months from June 2016 to August 2016. Rectal swabs were collected from the patients admitted to the ICU after a period of 48 h. The swab was inoculated onto a special selective media (ChromID ESBL media). The results were noted according to the color of the colony produced. These patients are followed for the development of infection and the ESBL-producing organisms. RESULTS: A total of 60 rectal swabs were cultured, 39 (65%) showed a positive result. Out of which, 22 (56%) were ESBL-producing E. coli and 17 (43%) Klebsiella spp. Twenty-three (38%) of the total patients screened were infected with ESBL-producing organisms. CONCLUSION: The study revealed high rates of carriage of ESBL producers in patients admitted to the ICU.

Taeniasis: An Unusual Presentation.

We report a case of 45-year-old male presenting with the history of nasal expulsion of segments of Taenia saginata. This route of expulsion is a rare occurrence. The report stresses this unusual presentation of taeniasis in endemic region.

A Case of Lower Respiratory Tract Infection with Canine-associated Pasteurella canis in a Patient with Chronic Obstructive Pulmonary Disease.

This is the report of lower respiratory tract infection with Pasteurella canis in a chronic obstructive pulmonary disease (COPD) patient with history of casual exposure to cats. Pasteurella species are part of the oral and gastrointestinal flora in the canine animals. These organisms are usually implicated in wound infection following animal bites, but can also be associated with a variety of infections including respiratory tract infections.

Bacteriologic profile and antibiogram of blood culture isolates in a pediatric care unit.

UNLABELLED: BACKGROUND / AIMS: Septicemia is one of the important causes of mortality and morbidity in neonates and children. Blood culture is the gold standard for the diagnosis. Emergence of multidrug resistant bacterial strains is a major problem in the management of sepsis. Present study was undertaken to identify the common bacterial pathogens associated with pediatric sepsis and to determine their antibiotic susceptibility pattern. MATERIALS AND METHODS: Blood cultures from 185 suspected cases of sepsis were examined. The growths from the subcultures were identified by conventional biochemical tests. Antibiotic susceptibility testing was performed by modified Kirby-Bauer disk diffusion method and drug resistant strains in primary screening were further processed for extended spectrum beta lactamases (ESBL) and methicillin resistant Staphylococcus aureus (MRSA) status by combination disk method (ESBL) and oxacillin disk diffusion method (MRSA). RESULTS: Out of the 185 cultures obtained from suspected cases, 81 (44%) were culture positive. Fifty-two (35%) of the culture isolates were Gram negative bacilli. Twenty-eight (64%) of the isolates were Gram positive cocci. One case was of mixed infection. The prevalence of MRSA in 41 strains of S. aureus was found to be 29% (12 strains). The overall prevalence of ESBL producers among 28 Gram negative bacterial isolates was found to be 32% (9 strains). CONCLUSION: This study stresses the need for the continuous screening and surveillance for antibiotic resistance in pediatric care unit.

Drug susceptibility profiles of Mycobacterium tuberculosis isolates at Mangalore.

BACKGROUND AND OBJECTIVES: Tuberculosis (TB) remains one of the major causes of death from a single infectious agent worldwide. Its resurgence in 1990s is primarily due to co-infection with HIV and the emergence of multi-drug-resistant (MDR) strains. Our objectives in this study were demonstration and grading of acid-fast bacilli in smears from sputum specimens of clinically newly diagnosed pulmonary TB patients, isolation of the organism, speciation and drug susceptibility testing of Mycobacterium tuberculosis isolates to isoniazid (H), rifampicin (R), streptomycin (S), and ethambutol (E). MATERIALS AND METHODS: Sputum specimens were collected from 150 patients. Smear examination was done after Ziehl-Neelsen staining. The specimens were cultured onto Lowenstein Jensen media after Petroff's method of concentration. The growth was identified as M. tuberculosis with standard tests. Sensitivity of 50 isolates of tubercle bacilli to anti-TB drugs H, R, S, E were determined by Resistance-Ratio method. RESULTS: Out of 150 sputum specimens examined, 62(41.3%) were smear positive. Out of these 62,56 grew on culture. 50 isolates of M. tuberculosis were picked up for drug susceptibility testing. Total of 31 (62%) were resistant to S, 14(28%) to H, 9(18%) to R, 6(12%) were resistant to E and 2 strains (4%) were resistant to H and R. CONCLUSION: From the small cohort, incidence of primary MDR-TB was found to be 4% in this region, which is within the expected range.