European Journal of Cardiovascular Medicine

Aim:  To determine the bacteriological profile and antibiogram of burn wound patients in teritiary care hospital.

Materials And Methods : A cross sectional descriptive study conducted  from January 2022- June 2022 and collected  50 specimens ( swabs ) from burn wound patients admitted in Burns ward  and processed in Microbiology Department ,Andhra Medical college, Visakhapatnam.  Drug susceptibility tests were performed using Kirby Bauer method   according to CLSI guidelines.

Results: Out of 50 samples , 42 samples  shown bacterial growth in which 34 bacterial isolates were GNB and 8 were GPC. Out 0f 42 , most frequently isolated was Pseudomonas aeurginosa ( 24 )(57.14% )of which 8 were ESBL producing , followed by Staph aureus ( 7) (16.66%), Klebsiella species (4)(9.52%), Acinetobacter species (4)(9.52% ) ,Escherischia coli (2)( 4.76%) ,Proteus species (1)(2.38% ). GNB were mostly sensitive to Piperacillin- Tazobactam, Fluoroquinolones, Macrolides and were  resistant to Beta lactams. GPC were sensitive to Vancomycin , Linezolid and were resistant to Cefoxitin .

Conclusion: Due to increased morbidity and mortality associated with burn wound infections, early detection and intervention are a prerequisite for better clinical outcomes of burn patients

Introduction: Ventilator associated pneumonia is defined as pneumonia occurring more than 48hours after the initiation of endotracheal intubation and the most common nosocomial infection in intensive care unit.VAP is second most common health care associated pneumonia in spite of wide range of preventive measures. Aim: To isolate the bacterial pathogens and their antibiogram of organisms causing VAP. Materials and Methods: Cross sectional descriptive study conducted for a period of 6 months i.e January 2022 - June 2022 in patients admitted in ICUs of King George hospital on ventilator for more than 48 hours. Endotracheal aspirates are collected and transported to department of Microbiology, AMC, Visakhapatnam. Results: From 50 endotracheal samples studied ,15(30%) were culture positive. Among them the most predominant organism is Pseudomonas aeruginosa 5(33.3%) followed by Methicillin resistant Staphylococcus aureus 4 (26.6%), Klebsiella species 3 (20%) and Acinetobacter species 3(20%).Gram negative bacilli were sensitive to Piperacillin – Tazobactam, fluoroquinolones, macrolides, Polymyxin whereas resistant to beta lactams.Gram positive cocci were 100% resistant to Cefoxitin, Oxacillin and sensitive to Linezolid and Vancomycin. Conclusion: Knowledge of incidence of VAP, their causative microbial flora along with their susceptibility pattern help in selection of appropriate antibiotics for therapeutic use and better outcome

Background: Persistent inflammation of the middle ear and mastoid cavity that manifests as recurrent ear discharge or otorrhoea due to a tympanic membrane perforation is known as chronic suppurative otitis media [1]. Objectives:  1) To categorize active chronic suppurative otitis media into tubotympanic and atticoantral disease. 2) To find out microbiological organisms responsible for both these categories (tubotympanic and atticoantral) and their sensitive drugs by culture and sensitivity report. Material & Methods: Study Design: Prospective Hospital based observational study. Study area: Department of E.N.T, Narayana Medical College and Hospital, Nellore, Andhra Pradesh. Study Period: June 2021 – May 2022.   Study population: Patients with CSOM of all age groups and both sexes attending the Narayana Medical College and Hospital, were selected randomly for the study. Sample size: study consisted a total of 50 cases. Sampling method: Simple random method. Results: Majority of pseudomonas infection showed mucopurulant type of discharge (50%) followed by S. aureus (33.33%). Purulent discharge was common in Pseudomonas (37.5%) and S. Aureus (37.5%). Mucoid discharge was common in Klebsiella (16.67%) followed by pseudomonas (27.78%) infection. It is interesting to know that 100% of no growth had mucoid discharge. Chi square was used to find the association between bacteria and discharge; and it was found not significant. Conclusion:  Out of 50 cases, 56 ears were examined, 51 pathogenic organisms were isolated. Only aerobic bacteria were isolated in the present series. P. aeruginosa was the most common organism isolated 23 (41.07%), followed by S. aureus 15 (26.79%), Klebsiella 5 (8.93%), E. coli 3 (5.36%), Proteus 3 (5.3%), Acinetobacter 1 (1.79%). No growth was found in 5 (8.93%) and commensal was found in 1 (1.8%) of discharge. Cf was the most effective antibiotic followed by Ak, G, Ce. In both TTD, AAD, no anaerobic organisms were cultured.

Introduction: Cystic fibrosis is a life-shortening disease of young children but it has been present in adults in recent days. Studies on epidemiology and microbiota of cystic fibrosis from the southern part of India are very few. So we tried to project the data of bacteria responsible for pulmonary exacerbations in cystic fibrosis patients and their antibiotic sensitivity. Materials and Methods: A total of 75 samples were collected from confirmed cystic fibrosis patients attending outpatient clinical departments and were processed for culture and sensitivity according to CLSI protocols. ESBL and MBL production among non fermenters were detected using antibiotic discs using modified Kirby bauer method. Results: Out of all isolated pathogens Pseudomonas aeruginosa isolates were 29 (40.8%), 15 (21.1%) isolates were Klebsiella pneumoniae, 12 (16.9%) Staphylococcus aureus, 7 (9.8%) Candida albicans, 4 (5.6%) Enterobacter cloacae, 2 (2.8%) Burkholderia cepacia, and 2 (2.8%) Burkholderia species. Out of 29 Pseudomonas aeruginosa isolates 68.9% showed ESBL production and 17.2% showed MBL production. All the Burkholderia cepacia tested were ESBL and MBL producers. 100% and 50% of Burkholderia species expressed ESBL and MBL enzymes respectively. Conclusion: Co-existence of S.aureus and P.aeruginosa in cystic fibrosis patients is still a matter of debate. Many hypotheses including the present study concluded that microorganisms are antagonistic invitro after a prolonged co-existence.

Introduction: The consequences of CSOM varies from hearing loss, persistent otorrhoea, mastoditis, labrynthitis, facial palsy and also leads to dangerous complications such as intracranial abscess and thrombosis. Chronic suppurative otitis media (CSOM) is persistent inflammation of the middle ear or mastoid cavity. The treatment of CSOM is also controversial as the microbiotia and susceptibility patterns keep changing from time to time and vary from region to region. So here we tried to project a data of cross sectional study which gives the epidemiology of CSOM and its microbiological study.  Materials and Methods: This is a cross sectional study on CSOM Patients from whom clinical details were collected.  All pus swabs were collected under aseptic precautions and processed for gram stain, culture, biochemical reactions and sensitivity testing as per recommendations. All the data entered in to Spread excel sheet for analysis. All descriptive quantitative variables were expressed as numbers and percentages. Results:  Unilateral CSOM is the most common complaint observed i.e, 63.1%. On audiometric examination 64.8% of patients had <40dB of hearing loss and the majority CSOM patients had conductive hearing loss (69.7%). Predominant pathogen isolated was Pseudomonas aeruginosa (33%) followed by Klebsiella pneumoniae (22%) and Staphylococcus aureus (19%). Pseudomonas aeruginosa which were isolated showed 96.9% susceptibility to amikacin, 81.8% to levofloxacin, 81.8% to Ceftazidime-clavulanic acid, 81.8% to piperacillin+tazobactum, 75.7% to ceftazidime, and 87.8% sensitive to meropenem. Conclusion: Complications of CSOM can be prevented by appropriate antibiotic usage according to the microbiological report, irrational use of antibiotics cause the increase in multidrug resistant pathogens so it is strongly recommended to test for microbiological culture and sensitivity prior to usage of antibiotics. Early microbiological ensues prompt and effective treatment to avoid such complications.

Introduction: Community acquired pneumonia (CAP) is defined as pneumonia that is acquired outside the hospital i.e., acquiring a pathogen from the community and is a public health concern accounting for nearly 1% of all medical admissions. Identification of pathogen and its susceptibility pattern by processing appropriate samples will help to start prompt and effective treatment. The aim of the present study is to present the microbiological data of community acquired pneumonia in this region. Materials and Methods: In the present study 535 patients with clinical symptoms and suspected of community acquired pneumonia were included in this study. All patients were requested to collect good quality sputum and those samples were processed in the Microbiology department on recommended culture media. Bacteria; isolation was done by biochemical tests. Antibiotic susceptibility testing was performed by conventional methods. Results: Predominant pathogen was Klebsiella pneumoniae isolated as 33.6% followed by Streptococcus pneumoniae (24.7%), Staphylococcus aureus (18.5%), Pseudomonas aeruginosa (15.04%), Enterobacter species (5.3%), and Acinetobacter species (2.65%). Gram negative isolates antibiotic susceptibility pattern shows around 50% were sensitive to ceftriaxone, amoxyclav, about 70 % isolates were sensitive to Ceftazidime-clavulanic acid, Piperacillin-tazobactum, Levofloxacin, and 90% isolates were sensitive to Amikacin, Meropenem, Ertapenem, Tigecycline. In this study  23.8% were Methicillin Resistant Staphylococcus aureus isolates. Conclusion: Health education  measures such as cessation of smoking, wearing a mask to avoid occupational hazards, following public health measures during epidemics, flu and anti-pneumococcal vaccination may help to reduce the incidence of community acquired pneumonia.

Background: Catheter-associated urinary tract infection (CAUTI) is one of the most prevalent health-related illnesses, account for almost half of all hospital-acquired diseases. The length of catheterization, ICU stay and procedure of catheterisation play a crucial role for developing catheter associated bacteriuria (CAB). Objectives: Aim of this study to determine the incidence and evaluate risk factors of CAB in medical intensive care unit patients Methods: Patients age >45 and <75 years requiring an in dwelling catheter for longer than 48 hours admitted in medical ICU were enrolled. A quantitative urine culture was performed once weekly or prior to removal of catheter or when clinical manifestations of UTI occurred (fever>38C, dysuria, suprapubic tenderness, pyuria). The following variables were estimated age, sex, duration of catheterisation, ICU stay and severity score at admission (Apache II). Results: A total of 110 patients required indwelling catheter were analysed. The incidence of CAB was 10.5% (12/110). Majority of the patients were 56-65 years age predominantly males. The length of ICU stay and duration of catheterisation was significantly associated with bacteriuria. Most common organism isolated from CAB was E. coli followed by Enterococcus species and Pseudomonas species Conclusion: Proper aseptic insertion, maintenance of the catheter by trained personnel, justified use of urinary catheterization and the removal of the catheter as soon as feasible were the key factors to prevent CAB.

Introduction: India has a diabetic population of about 50.8 million, which is expected to increase to 87 million by 2030. Infection worsens the wound condition, delays the healing mechanism, and if appropriate measures are not taken in time, it could lead to systemic infection, septicemia, amputation, or even death. Diabetic foot problems, such as ulcerations, diseases, and gangrene, are the most common cause of hospitalization among diabetic patients. Objective: To determine the microbiological profile and antibiotic susceptibility patterns of organisms isolated from diabetic foot ulcers. Material and methods: A six-month retrospective study was carried out between January 2023 and June 2023 in the Department of Microbiology Government Medical College Anantapur. 250 Wound swabs were collected from diabetic foot ulcer patients and processed per the standard procedure. Antibiotic sensitivity testing was performed using the Kirby Bauer disc diffusion method by CLSI guidelines. Results: Out of 250 samples, 175 (70%) samples yielded growth. Among 175 GNB 124 (70.8%) and GPC 51 (21.6%). Conclusion: In this study, among Gram-negative bacilli, Pseudomonas aeruginosa was the predominant organism 45(36.2%), followed by Escherichia coli 32(25.8%). Among Gram positive cocci, Staphylococcus aureus are 27 (52.9%) out of 27staphylococcus aureus 12 (44.4%) were resistant to Methicillin [MRSA].  The antibiotic profile shows that proper antibiotic usage, if enacted through institutional policy, can reduce morbidity among diabetic foot ulcer patients.

Background: Pseudomonas aeruginosa is one of the most common bacteria to cause infections in both community and hospital settings. Its ability to survive in varied environmental conditions, various virulence factors, and multi-drug resistance patterns has helped the organism cause difficulty in treating infection. Objectives: The objective of the study was to know the prevalence of Pseudomonas isolates and in particular P. aeruginosa isolates in varied clinical specimens and to assess the antimicrobial susceptibility patterns of P. aeruginosa as well as its magnitude of multidrug resistance (MDR) in a tertiary care hospital in Eastern India. Materials & Methods: A total of 206 confirmed isolates of Pseudomonas isolates from various clinical samples were studied. Identification and speciation of the isolates and their antibiotic susceptibility testing were determined by conventional and automated methods (Vitek 2 compact). Results: Out of the 206 isolates of Pseudomonas, 143 isolates were P. aeruginosa, the majority (44.75%) were from pus samples. Resistance to amikacin and gentamycin was 34% and 36%, ciprofloxacin and levofloxacin were 32.8% and 35%, Resistance to ceftazidime and cefepime were 43.4% and 49.6%. Imipenem and meropenem showed 37% and 35% resistance, respectively. Resistance to piperacillin-tazobactam was only 35%. Conclusion: There is increased resistance to cephalosporins, aminoglycosides, carbapenems and beta lactamase inhibitors. To restrict the inappropriate use of antimicrobial agents and the development of MDR, there is a need to continuously monitor and document the prevailing resistance pattern in a particular geographical area

Aims: To know the spectrum of the aerobic bacteria causing post operative wound infections. Materials and methods: The present study was undertaken to know the bacteriological profile of SSIs in Obstetrics & Gynaecology ward, including their antibiogram and find the preventive measures. Age group 20-60 years, Presence of post operative SSI’s, involves only the skin or subcutaneous tissue were included in study. Results: In 94(45.7%) culture isolates, 42(44.70%) were Gram negative enteric rods, 26(27.65%) were Staphylococcus species and 26(27.65%) were Non fermenters. Predominant isolates were Klebsiella pneumoniae (28.72%) Pseudomonas aeruginosa (25.53%) & Staphylococcus aureus (17.04%) respectively. Wound infection rate was more in emergency Obstetric cases (96.3%) compared to elective cases of Gynaec (77%) & Obstetric (73.3%). Methicillin resistant CoNS (60%). 6 CoNS were resistant out of 10 isolates which is significant hence speciation of CoNS should be done. Antibiogram in sensitive strains of Enterobacteriaceae shows highest sensitivity to Amikacin (86.3%). The antibiogram in resistant strains of Enterobacteriaceae shows highest sensitivity to Colistin (95%) & Imipenem (90%) and lowest sensitivity to AmoxyClav (30%). Sensitivity pattern in non-fermenters shows highest sensitivity to Imipenem (88.46%), whereas MBL producers shows highest sensitive to Colistin (100%) & Polymyxin (100%). Antibiogram of the Staphylococcus species shows highest sensitive to Clindamicin (100%) whereas for MRSA strains highest sensitive to Linezolid (100%). Conclusion: Drug resistance mechanisms which include ESBL, Amp C betalactamases, MBL producers exhibited by the predominant Gram-negative rods and MRSA strains in Gram positive isolates are due to overuse of antibiotics leading to selective pressure. Government has to intervene in strict implementation of antibiotic policy in all health care institutions. Availability of drug to patient is restricted only on doctor prescription.

Background: Nosocomial infections are a serious threat in healthcare settings, particularly in paediatric intensive care units (PICU), and understanding the microbiological landscape is crucial for effective infection control and improved patient outcomes. This study seeks to identify and characterize the microorganisms present in the PICU and their resistance to antibiotics. Methods: This study was prospective observational research in the PICU. Various samples (blood, urine, endotracheal aspirates, swabs etc) were collected and analysed. Antimicrobial susceptibility testing was performed using the vitek-2 compact system. Results were interpreted according to CLSI guidelines (2022). Positive isolates were categorized and their antimicrobial susceptibility and resistance patterns were documented and presented as the number of isolates and percentage of resistance to specific agents. Results: 111 out of 1116 culture samples were positive (9.94% positivity rate). Blood culture was most common (41.4%), followed by endotracheal (31.5%) and urine (12.6%) cultures. Most positive patients were children under 6 years old (76%). Coagulase negative staphylococcus aureus (CONS) and Acinetobacter species were the most frequent bacteria (18% and 18.9% respectively). Resistance rates were high for benzathine penicillin and quinolones whereas linezolid and daptomycin were most effective against gram-positive organisms. Carbapenems, Colistin, and tigecycline were most effective against gram-negative isolates. Extended spectrum beta-lactam (ESBL) resistance was high in Acinetobacter spp., klebsiella, E. coli, and pseudomonas spp. Conclusions: The study highlights the importance of understanding the microbiological landscape in paediatric intensive care unit to implement effective infection control measures and select appropriate antimicrobial therapies.

Introduction: Implantation of cardiac implantable electrophysiological devices (CIEDs), including permanent pacemakers and implantable cardioverter-defibrillators has been on the rise over the past years, largely due to the expanded indications for CIED implantation for primary prevention. Infection associated with implantable devices is a serious complication with high morbidity leading to mortality. The importance of appropriate empirical antibiotic coverage is illustrated by studies that document the association between inappropriate selection and increased mortality in patients with permanent pacemaker implantation. Increasing multi drug resistance problem could be due to mutations, over use of broad-spectrum antibiotics, across the counter availability of antibiotics and lack of infection control policy in the hospital settings. Methodology: A prospective observational study conducted at the major tertiary care centre of the State of Himachal Pradesh, for duration of one year. Patients who had undergone interventional cardiology procedure and developing any sign or symptom of general or systemic infection were included. Results: On direct Gram staining of clinical samples, microorganisms were seen in 12 (70.58%) samples and in 5 (29.41%) samples no microorganism seen. Out of 12 positive samples, Gram positive cocci were isolated from ten samples accounting for 83.33% of total isolates, while Gram negative bacilli were isolated from one sample (8.33%) and both Gram positive cocci and Gram-negative bacilli were isolated from single sample accounting for 8.33% of total isolates. Majority of the isolates were S.aureus (46%), followed by S.epidermidis (38%). Pseudomonas aeruginosa and Achromobacter spp. were 8% each. Out of 11 Staphylococcus isolates, 6 (54.54%) were identified as Staphylococcus aureus (S.aureus) and 5 (45.45%) were Staphylococcus epidermidis (S.epidermidis). There was 100% sensitivity to Vancomycin, Daptomycin and Linezolid. Almost 64% samples were resistant to Oxacillin, Cefoxitin, Cefazolin and Erythromycin; 45% were resistant to Co-trimoxazole and Clindamycin; 18% were resistant to Gentamicin and 9% were resistant to teicoplanin and Rifampicin. All the isolates were resistant to Ampicillin and Penicillin G. Out of 6 isolates of S.aureus, 3 (50%) were MRSA. Out of 5 isolates of S.epidermidis 4 (80%) were Methicillin resistant. All the MRSA isolates were sensitive to daptomycin, teicoplanin, vancomycin, linezolid and rifampicin but they were resistant to erythromycin, ampicillin and penicillin G. 67% isolates were sensitive to gentamicin, co-trimoxazole and clindamycin. All Methicillin resistant S.epidermidis were sensitive to daptomycin, vancomycin and linezolid. 75% were sensitive to gentamicin, teicoplanin and rifampicin and only 25% were sensitive to co-trimoxazole. However, all were resistant to erythromycin and clindamycin. In single isolate of Achromobacter spp resistance was observed for gentamicin, imipenem, meropenem, ciprofloxacin, levofloxacin and tetracycline. The isolate was sensitive to ceftazidime, piperacillin-tazobactam and co-trimoxazole. Single isolate of Pseudomonas aeruginosa was sensitive to amikacin, gentamicin, imipenem, meropenem, ceftazidime, cefepime, aztreonam, ciprofloxacin, levofloxacin and piperacillin-tazobactam. Conclusion: The present study indicated an infection rate of 8.1% following permanent pacemaker implantation. 84% of the causative organisms were Staphylococcus species and out of which 64% were methicillin resistant. Staphylococcus has been reported as a major cause of community and hospital acquired infections. Infections caused by Staphylococcus used to respond to β-lactam and related group of antibiotics. Vancomycin has been used as the drug of choice for treating MRSA infections. Further, the regular surveillance of hospital associated infections including monitoring antibiotic sensitivity pattern of MRSA and formulation of definite antibiotic policy may be useful for reducing the incidence of MRSA infection.

Background- Pseudomonas aeruginosa is an important opportunistic pathogen associated with chronic and recurrent infections, largely attributed to its ability to form biofilms. This study aimed to assess the biofilm-forming capacity of P. aeruginosa isolated from various clinical samples and evaluate the correlation between biofilm formation and antimicrobial susceptibility patterns (MTPM). Material and methods- The present study was conducted in the department of Microbiology, GMC, Kota (Rajasthan), India. 225 non-duplicate isolates of Pseudomonas aeruginosa from various clinical samples such as pus, urine, sputum, ET and body fluids were taken for the study. All isolates were subjected to routine antibiotic susceptibility testing by Kirby Bauer Disc Diffusion method. Biofilm production seen by Microtiter plate method. Result- Out of 225 sample, 155 (68.88%) were from males and 70 (31.11%) were from females. Ps. aeruginosa most commonly isolated from  59-69 age group. The maximum number of isolates was obtained from sputum 68 (30%), followed by urine 59 (26%), pus 57 (25%), body fluids 26 (12%), and endotracheal tube 15 (7%). In the present study, P. aeruginosa showed resistance against most of the commonly used antibiotics. Out of 225 isolates, 110 (48.88%) of P. aeruginosa isolates were identified as MDR and 115 (51.11%) of isolates were susceptible to most commonly used antibiotics. All 225 isolates were tested for biofilm production by MTPM. Among the MDR isolates, 53 (48.1%) were biofilm producers and 57 (51.8%) were non-biofilm producers. Biofilm producing isolates showed more resistance as compared to non-biofilm producers. The observed difference between biofilm formation for multidrug resistant and susceptible isolates was found to be statistically significant. Conclusion: The study found that biofilm-forming P. aeruginosa isolates exhibited higher resistance to commonly used antibiotics, particularly carbapenems and cephalosporins. These findings emphasize the need for effective biofilm-targeted therapeutic strategies in the management of P. aeruginosa infections in tertiary care settings.

Background:  Corneal ulcer is a potentially sight threatening ocular condition and the leading cause of monocular blindness in developing countries. Infectious keratitis can be caused by various pathogens i.e, bacteria, fungi, virus and parasites. Ocular trauma is a far more common predisposing factor of infectious keratitis in developing countries, whereas pre-existing ocular disease and contact lens are common risk factors in developed countries. Hence, an understanding of the aetiologic agents, epidemiologic features and risk factors that occur in specific region are important in rapid recognition, timely institution of therapy, optimal management and prevention of disease entity. Materials and methods: All patients with suspected infectious central corneal ulceration presenting to the ocular microbiology and cornea service. Sociodemographic data and information pertaining to risk factors were recorded, all patients were examined, and corneal cultures and scrapings were performed. Result: A total of 78 patients identified with bacterial corneal ulcer of which 58.97% were males, 37.17% were farmers. Trauma was seen as major predisposing factor in 75.64% cases. The major etiological agent was found in our study was Staphylococcus aureus (60.25%) followed by Pseudomonas in 16.66% and mixed infection in 7.69%. Conclusion: Bacteria are the most common cause of infectious keratitis in this patient population, with coagulase-negative Staphylococcus and Pseudomonas as the most common isolates. The prevalence of culture-positive fungal keratitis is significantly lower than that of bacterial keratitis. Contact lens wear is the most common risk factor associated with infectious keratitis.

Background: Bronchiectasis is a chronic respiratory disorder characterized by irreversible bronchial dilatation, recurrent infections, and progressive lung damage. While cystic fibrosis-associated bronchiectasis has been extensively studied, non-cystic fibrosis bronchiectasis (NCFB) remains under-recognized. Etiological factors and clinical presentations vary geographically, necessitating region-specific studies. This study aims to assess the microbiological profile and radiological patterns in patients with bronchiectasis at a tertiary care center in North India Methods: A cross-sectional study was conducted at the Department of Pulmonary and Critical Care Medicine, King George's Medical University (KGMU), Lucknow, between May 2024 and November 2024. A total of 70 patients diagnosed with bronchiectasis were enrolled. Clinical evaluation, high-resolution computed tomography (HRCT) of the thorax, and microbiological assessment, including sputum and bronchoalveolar lavage (BAL) cultures, were performed. The antimicrobial susceptibility of isolated pathogens was analyzed. Statistical analysis was conducted using descriptive methods, with a significance level set at p < 0.05. Results: Among 70 patients, 55.7% were female, and the majority (51.2%) were aged 61–70 years. The most common symptoms included cough (73.2%), sputum production (70.7%), and dyspnea (60.9%). HRCT findings revealed a predominance of cystic (46.3%) and cylindrical (39%) patterns, with 65.9% of cases showing bilateral lung involvement. Microbiological analysis identified Pseudomonas aeruginosa (44.3%) as the most frequently isolated pathogen, followed by Klebsiella pneumoniae (27.1%). Patients with Pseudomonas aeruginosa exhibited more severe radiological involvement, including multilobar and cystic patterns. Conclusion: This study highlights the significant burden of bronchiectasis in elderly patients, with post-tuberculosis sequelae being a predominant etiological factor. Pseudomonas aeruginosa colonization is associated with more extensive radiological involvement, underscoring the need for targeted antimicrobial strategies. Comprehensive management approaches should address both underlying etiologies and associated comorbidities to improve patient outcomes.

Background: Neonatal sepsis remains a leading cause of morbidity and mortality among newborns, requiring early diagnosis and appropriate antimicrobial therapy. This study aims to evaluate the bacteriological profile and antimicrobial sensitivity patterns of blood culture isolates in neonates with sepsis admitted to the Neonatal Intensive Care Unit (NICU) at GGH, Guntur. Methods :A prospective observational study was conducted on 150 neonates diagnosed with sepsis. Blood culture samples were analyzed to identify causative organisms and their antimicrobial susceptibility patterns. Clinical, maternal, and neonatal risk factors were documented. Statistical analysis was performed using SPSS v16, with significance set at p < 0.05. Results: Among the 150 neonates, late-onset sepsis (60%) was more common than early-onset sepsis (40%). Klebsiella (60.7%) was the predominant pathogen, followed by Staphylococcus aureus (22%), Pseudomonas (9.3%), and Acinetobacter (8%). Prematurity (44.6%) and perinatal asphyxia (36%) were significant neonatal risk factors. CRP positivity (89.3%) was observed in most cases. Antibiotic resistance was highest for ampicillin and cefotaxime, while piperacillin/tazobactam and meropenem were effective against Gram-negative isolates. Vancomycin remained effective against Staphylococcus aureus. Overall mortality was 21.3%, with Klebsiella infections associated with the highest fatality rate. Conclusion: Neonatal sepsis is primarily caused by Gram-negative bacteria, with Klebsiella and Staphylococcus aureus being the most common pathogens. The study highlights the increasing resistance to first-line antibiotics, emphasizing the need for regular antimicrobial surveillance and targeted therapy to improve neonatal outcomes

Pulmonary arterial hypertension (PAH) is a rare and progressive condition characterized by elevated blood pressure in the pulmonary arteries, often presenting with symptoms such as dyspnea, fatigue, and chest pain, particularly during exertion. This case report details a 37-year-old male patient with a history of kyphoscoliosis, who was referred for evaluation due to worsening breathlessness, anxiety, and abdominal distention over the past year. Clinical examination revealed significant cyanosis and respiratory distress, with imaging studies confirming PAH indicated by dilated pulmonary arteries and an enlarged cardiac silhouette. The patient's complex presentation also included mild hepatic changes and the identification of Pseudomonas aeruginosa, suggesting possible infection. This case underscores the challenges in diagnosing PAH, particularly in patients with multifactorial health issues. It emphasizes the necessity for comprehensive evaluations, including imaging and hemodynamic assessments, to facilitate timely and accurate diagnosis. A multidisciplinary approach to management is crucial for improving patient outcomes, highlighting the importance of early recognition and individualized treatment strategies to enhance quality of life in PAH patients.

Background: Pseudomonas aeruginosa is a major contributor to hospital-acquired infections (HAIs), with metallo-beta-lactamase (MBL) production driving resistance to carbapenems, a critical therapeutic class. In Western India, where healthcare systems face resource constraints and high patient loads, the epidemiology of MBL-producing P. aeruginosa remains underexplored. This study investigates the prevalence and mechanisms of MBL production in P. aeruginosa isolates from HAIs in this region. Methods: Between January 2023 and March 2025, 200 non-duplicate P. aeruginosa isolates were collected from HAIs across five tertiary care hospitals in Western India (Silvassa, Mumbai, Pune, Ahmedabad, and Jaipur). Isolates were identified using VITEK 2 and subjected to antibiotic susceptibility testing via Kirby-Bauer disk diffusion and E-test for carbapenems. MBL production was detected phenotypically using the imipenem-EDTA combined disk test and genotypically via PCR targeting blaNDM, blaVIM, blaIMP, and blaSPM genes. Plasmid analysis and conjugation experiments assessed resistance transferability. Results: MBL production was confirmed in 128 isolates (64%, 95% CI: 57.2–70.8%), with the highest prevalence in ventilator-associated pneumonia (72%) and bloodstream infections (62.5%). Resistance to meropenem (89.8%) and imipenem (84.4%) was predominant among MBL producers, alongside significant resistance to ceftazidime (78.1%) and piperacillin-tazobactam (68.8%). blaNDM-1 was the most common MBL gene (60.9%), followed by blaVIM (29.7%), with 94.4% of MBL genes located on conjugative plasmids transferable to Escherichia coli J53 in 86.4% of cases. MBL production correlated with prolonged ICU stays (66.4%) and higher mortality (21.9%). Conclusion: The 64% prevalence of MBL-producing P. aeruginosa in Western India, driven by plasmid-mediated blaNDM-1 and blaVIM, signals a critical resistance burden in HAIs. These findings highlight the urgent need for enhanced infection control, molecular surveillance, and antibiotic stewardship to curb the spread of MDR pathogens in this region.

Background: Neonatal sepsis remains a major cause of morbidity and mortality, particularly in rural healthcare settings with limited diagnostic and therapeutic resources. Understanding the microbial profile and antibiotic resistance trends is essential for guiding empirical therapy and improving clinical outcomes. Materials and Methods: A retrospective study was conducted in the neonatal intensive care unit (NICU) of a rural tertiary hospital over a five-year period (January 2019 to December 2023). Blood culture reports from neonates with clinically suspected sepsis were reviewed. Positive cultures were analyzed to determine the prevalence of bacterial isolates and their antibiotic susceptibility patterns using the standard Kirby-Bauer disk diffusion method in accordance with CLSI guidelines. Results: Out of 1240 neonates evaluated for sepsis, 368 (29.7%) had culture-positive results. Gram-negative organisms constituted 62% of the isolates, with Klebsiella pneumoniae (27%), Escherichia coli (18%), and Pseudomonas aeruginosa (9%) being predominant. Among Gram-positive isolates, Staphylococcus aureus (15%) and Enterococcus spp. (6%) were most common. High resistance was observed against ampicillin (78%), cefotaxime (64%), and gentamicin (55%). Carbapenems retained the highest sensitivity among Gram-negative isolates, while vancomycin and linezolid showed effectiveness against Gram-positive organisms. A rising trend in multidrug-resistant organisms was noted over the study duration. Conclusion: The study highlights a high burden of Gram-negative infections and an alarming rate of antimicrobial resistance among neonatal sepsis cases in rural settings. Regular surveillance of bacterial profiles and antibiotic susceptibility is critical for formulating effective empirical treatment strategies and curbing resistance

Background: Ventilator-associated pneumonia (VAP) remains a major cause of morbidity and mortality among patients in intensive care units (ICUs), particularly in settings with high antimicrobial usage and multidrug-resistant (MDR) organisms. Objective: To study the spectrum and antibiotic resistance pattern of bacterial pathogens isolated from VAP cases in a tertiary care hospital. Methods: A prospective observational study was conducted over 12 months in the ICU. Bacterial isolates from endotracheal aspirates and BAL samples of VAP-diagnosed patients were identified, and antimicrobial susceptibility was tested. Results: Of 150 patients with clinical VAP, 134 yielded positive cultures. Predominant isolates included Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae. High resistance was observed against cephalosporins and carbapenems. Colistin remained the most effective antimicrobial. Conclusion: The high prevalence of MDR pathogens in VAP cases necessitates continuous surveillance and strict antimicrobial stewardship.

Background: Gastrointestinal surgery is frequently associated with an increased risk of surgical site infections (SSIs), contributing to considerable morbidity and financial burden. However, data on SSIs in Indian settings, which are characterised by resource scarcity, remain limited. This study aimed to investigate the incidence of SSI and identify factors associated with gastrointestinal surgeries in a hospital setting in India. Materials and Methods: This prospective observational study was conducted at tertiary care hospital. We collected data from 300 patients who underwent gastrointestinal surgery in the Department of General Surgery were included. Sociodemographic details, obesity status, and medical history, including anaemia, diabetes, and hypoproteinaemia, were recorded. The surgical plan (elective or emergency), wound class, surgery duration, and causative organisms were collected. Result: Of the 300 patients, 31 were infected (10.3% infection rate). Among males (n=190), 22 (11.57%) developed infections compared to 9 (8.18%) females (n=110). Surgeries under 2 h had a 7.90% infection rate (19 out of 240 cases), while longer surgeries accounted for 20% (12 out of 60 cases). Elective surgeries had a lower infection rate (2.70%) than did emergency surgeries (21.60%). The dominant causative organisms were Pseudomonas (45.10%), Klebsiella (25.80%), Escherichia coli (22.50%), and Streptococcus (6.45%). Risk factors were significantly associated with anaemia (30.90% infection rate), diabetes mellitus (34%), hypoproteinaemia (26.30%), and obesity (23.70%). Conclusion: This study highlights the significant risk factors for SSI, including diabetes, obesity, anaemia, and hypoproteinaemia, with Pseudomonas as the most common causative organism. Identifying these risks allows surgeons to implement targeted SSI prevention strategies, particularly in resource-limited settings with unclear SSI reduction policies.

Background: Urinary tract infections (UTIs) are among the most common bacterial infections in Pediatric patients. The emergence of antibiotic-resistant uropathogens has complicated empirical treatment strategies, necessitating continuous surveillance of resistance patterns.  Objectives: To evaluate the distribution of uropathogens and their antibiotic resistance profiles in pediatric UTIs over a 12-month period. Methods: A longitudinal observational study was conducted over one year in a tertiary care hospital. A total of 100 pediatric patients (aged 1 month to 12 years) clinically diagnosed with UTI were enrolled. Midstream urine samples were collected and processed for culture and sensitivity. The isolated organisms were identified, and antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method according to CLSI guidelines. Multidrug resistance (MDR) was defined as resistance to three or more antibiotic classes. Results: Escherichia coli was the most common isolate (66%), followed by Klebsiella pneumoniae (14%), Proteus mirabilis (8%), Enterococcus faecalis (6%), and Pseudomonas aeruginosa (4%). High resistance rates were observed for ampicillin (84.8% in E. coli, 92.9% in Klebsiella), cotrimoxazole, and ciprofloxacin. Nitrofurantoin and imipenem retained better sensitivity. Overall, 38% of isolates exhibited multidrug resistance. A rising trend in resistance to ampicillin and cotrimoxazole was noted over the study period.  Conclusion: This study highlights the alarming prevalence of antimicrobial resistance in pediatric UTIs, particularly among Gram-negative organisms. Regular monitoring of resistance patterns is essential to guide empirical therapy and limit the spread of MDR pathogens.

Background: Diabetic foot ulcers (DFUs) are a serious complication of diabetes mellitus and a leading cause of hospital admissions, infection, and limb loss. The microbial profile of these ulcers and their relationship to glycemic control and clinical outcomes varies geographically and remains underreported in central India. Methods: This prospective observational study was conducted over 12 months at a tertiary care hospital in Chhattisgarh, India. A total of 100 adult patients with diabetic foot ulcers were enrolled. Clinical evaluation included Wagner grading, ulcer measurement, and HbA1c analysis. Wound specimens were collected for aerobic culture and antimicrobial sensitivity testing. Patients received standard medical and surgical care, and outcomes were tracked during follow-up. Associations between microbiological profile, ulcer severity, glycemic control, and surgical intervention were analyzed using ANOVA and chi-square tests. Results: The majority of patients were male (62%), with a mean age of 54.38 ± 11.61 years. Most ulcers were Wagner grade 2 (63%). Poorer glycemic control was significantly associated with higher Wagner grades (p < 0.05). Culture positivity was observed in 82% of cases, with Escherichia coli (26.8%) as the most common isolate, followed by Pseudomonas spp. and coagulase-negative staphylococci (17.1% each). Gram-negative organisms predominated. Antibiotic resistance to commonly used agents was high, but most isolates were sensitive to gentamicin, imipenem, and amikacin. Debridement was performed in 73% of patients; minor and major amputations were required in 22% and 5%, respectively. A statistically significant association was found between Wagner grade and the extent of surgical intervention (p = 0.001). Conclusions: The study revealed a predominance of gram-negative infections in DFUs, with significant antibiotic resistance patterns. Glycemic control and Wagner grade were strong predictors of infection severity and surgical outcome. Early microbiological diagnosis and targeted therapy remain essential for limb salvage in diabetic foot management.

Background: The most frequent hospital-acquired illness (HAI) is still catheter-associated urinary tract infections (CAUTI). This highlights the necessity of putting in place and keeping an eye on efficient infection management measures in order to lower the risk of CAUTI. Aims: The current study's objectives were to compute CAUTI rat and identify the etiology with drug susceptibility. Materials & Methods: Catheter-associated urinary tract infections (CAUTIs) are a common healthcare-associated infection caused by prolonged catheter use. Effective prevention methods include maintaining sterile insertion techniques, ensuring proper catheter care, minimizing catheter use, and prompt removal when no longer needed. The antibiotic sensitivity pattern of uropathogens causing CAUTIs highlights the importance of monitoring local resistance trends to guide treatment. Common uropathogens include Escherichia coli, Klebsiella spp., and Pseudomonas aeruginosa, which often exhibit resistance to multiple antibiotics. Empirical therapy should be tailored based on antibiograms to avoid resistance development and ensure effective treatment. Result: Antimicrobial resistance (AMR) among uropathogens is a significant global challenge, with varying resistance profiles across pathogens. E. coli demonstrated moderate susceptibility to ampicillin and piperacillin-tazobactam but showed high resistance to amoxicillin-clavulanate and ceftriaxone. K. pneumoniae exhibited extensive resistance, including 100% resistance to several antibiotics, though partial susceptibility to some aminoglycosides and ceftazidime was observed. P. aeruginosa displayed multidrug resistance, with susceptibility limited to carbapenems like imipenem and meropenem. Acinetobacter species showed pan-resistance to all tested antibiotics, highlighting a severe clinical threat. These findings stress the urgent need for antimicrobial stewardship, novel therapies, and robust resistance surveillance systems. Conclusion:  We concluded that CAUTI continued to pose a serious threat to patient safety and to the infection control team. A major factor in lowering CAUTI rates, which in turn lowers patient morbidity and hospital stays, is the implementation of appropriate care bundles and ongoing training for healthcare professionals. Multidrug-resistant uropathogens such as E. coli and Klebsiella spp.

Background: Globally, surgical site infections are the most reported healthcare-associated infection and a common surgical complication. In developing countries such as India, there is a paucity of published reports on the microbiologic profile and resistance patterns of isolates. Objective: This study aimed to assess the bacterial profile and antimicrobial susceptibility patterns of isolates among patients diagnosed with surgical site infection at a tertiary teaching hospital in Northeast India. Methods: A hospital-based study was employed among adult patients who underwent either elective or emergency surgical procedures. All the eligible patients were followed for 30 days for the occurrence of surgical site infection (SSI). From those who developed SSI, infected wound specimens were collected and studied bacteriologically. Results: Of 251 study participants, 122 (48.6%) were females. The mean ± SD age of the patients was 38 ± 16.30 years. The overall postoperative surgical site infection was observed in 118 patients, and of these, 73.7% (87/118) were culture positive. On Gram stain analysis, 71.1% of them were Gram-negative, 25.3% were Gram-positive, and 3.6% were a mixture of two microbial growths. Escherichia coli accounted for 34.48% followed by Staphylococcus aureus (20.69%), Klebsiella pneumoniae (19.54%), Proteus mirabilis (4.59%), Acinetobacter spp (4.59%), Citrobacter spp (4.59%), Pseudomonas aeruginosa (3.44%), Enterococcus faecium (2.29%), Klebsiella oxytoca (2.29%), and Proteus vulgaris (1.15%) Conclusion: Gram-negative bacteria were the most dominant isolates from surgical sites in the study area. Among the Gram-negative bacilli, Escherichia coli was the most common bacterium causing surgical site infections. Given the high antibiotic resistance observed in the current study, it is necessary to conduct routine microbial analysis of samples and their antibiogram.