Footprints of human melioidosis in the north western Indian states, expanding endemicity in India.

Melioidosis is endemic in India and well described from western and eastern coastal states. Sporadic cases of melioidosis have been diagnosed from Gujarat prior to current case series in patient with travel history to endemic areas. We noticed a rise in melioidosis cases from Gujarat and Rajasthan in the last two years. With this case series, we are reporting eleven melioidosis cases who have no travel history to endemic areas and acquired melioidosis locally. This case series alerts practicing clinicians in Gujarat and Rajasthan to look for and keep melioidosis as one of the differential diagnosis in appropriate clinical syndrome.

Melioidosis in Gujarat: a neglected tropical disease.

We report what we believe is the first case in Gujarat of melioidosis in a 67-year-old man. Awareness of this disease is limited, especially in areas supposed not to be endemic.

Nonfermenting Gram-negative Bacilli other than Pseudomonas aeruginosa and Acinetobacter Spp. Causing Respiratory Tract Infections in a Tertiary Care Center.

BACKGROUND: Nonfermenting gram-negative bacilli have emerged as important healthcare-associated pathogens. It is important to correctly identify all clinically significant nonfermenting gram-negative bacilli considering the intrinsic multidrug resistance exhibited by these bacteria. MATERIALS AND METHODS: A retrospective study was undertaken to identify the various nonfermenting gram-negative bacilli other than Pseudomonas aeruginosa and Acinetobacter spp. isolated from respiratory samples (n = 9363), to understand their clinical relevance and to analyze their antibiotic susceptibility pattern. RESULTS: Nonfermenting gram-negative bacilli were isolated from 830 (16.4%) samples showing significant growth. Thirty-three (4%) isolates constituted nonfermenting gram-negative bacilli other than P. aeruginosa and Acinetobacter spp. Stenotrophomonas maltophilia (15, 45.5%) was the most common isolate followed by Burkholderia cepacia (4, 12.1%), Sphingomonas paucimobilis (3, 9.1%), and Achromobacter xylosoxidans (3, 9.1%). On the basis of clinicomicrobiological correlation, pathogenicity was observed in 69.7% (n = 23) isolates. Timely and correct treatment resulted in clinical improvement in 87.9% cases. CONCLUSION: Any nonfermenting gram-negative bacilli isolated from respiratory tract infection should not be ignored as mere contaminant, but correlated clinically for its pathogenic potential and identified using standard methods so as to institute appropriate and timely antibiotic coverage.