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The association of tuberculosis and type 2 diabetes mellitus has been a recognized re-emerging challenge in management of the convergence of the two epidemics. Though much of the literature has studied this association, there is less knowledge in the field of genetic diversities that might occur in strains infecting tuberculosis patients with and without diabetes. Our study focused on determining the extent of diversity of genotypes of Mycobacterium tuberculosis in both these categories of patients. We subjected 55 M. tuberculosis isolates from patients diagnosed with pulmonary TB with and without type 2 diabetes mellitus to whole-genome sequencing on Illumina Hi Seq platform. The most common lineage identified was lineage 1, the Indo-Oceanic lineage (n = 22%), followed by lineage 4, the Euro-American lineage (n = 18, 33%); lineage 3, the East-African Indian lineage (n = 13, 24%); and lineage 2, the East-Asian lineage (n = 1, 2%). There were no significant differences in the distribution of lineages in both diabetics and non-diabetics in the South Indian population, and further studies involving computational analysis and comparative transcriptomics are needed to provide deeper insights.
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Salmonella enterica serovar Kentucky is an emerging human pathogen in developed countries and also a concern for public health in developing countries. Although genus Salmonella is usually susceptible to many antimicrobial agents, a recent increase in resistance has become a cause for concern. A case of ceftriaxone resistant Salmonella enterica serovar Kentucky causing bacteremia and acute gastroenteritis is reported in this paper. The Salmonella Kentucky isolate in this case was resistant to most classes of antibiotics. This is the first case report of Salmonella enterica serovar Kentucky resistant to ceftriaxone. Multidrug resistant patterns of Salmonella Kentucky are observed globally. Awareness of various nontyphoid Salmonella causing human infections is of utmost importance, because delayed identification, serotyping, and susceptibility testing may delay the administration of antibiotics leading to worsening outcomes.
RESUMO
Background and Objectives: Acinetobacter baumannii has emerged as a major organism accounting for hospital acquired infections particularly in intensive care units. Due to production of different kinds of beta lactamases these bacteria have developed drug resistance rendering the treatment of such infections very difficult and expensive. Rapid identification of A. baumannii producing such beta-lactamases is the need of the hour in reducing morbidity and mortality associated with A. baumannii infections. Materials and Methods: A. baumannii was isolated from clinical samples like endotracheal aspirates, sputum, urine, exudates using standard culture techniques. Identification and drug sensitivity was done using Vitek 2 system. All the isolates were subjected to detection of ESBLs using phenotypic confirmatory test, plasmid mediated AmpC beta-lactamase by AmpC disc test, Carbapenemase production by CarbAcineto NP Test and Modified hodge method. Results: 149 A. baumannii isolates were analysed for antimicrobial susceptibility and various beta-lactamase production. Results were evaluated for statistical significance using Chi-Square and P value. 81.8% of isolates were from male patients with majority of them above 50 years of age. 88.5% of samples were from ventilator associated pneumonia patients. 83.8% of isolates were sensitive to tigecycline. Only 10% to 12% of isolates were sensitive to carbapenems. 23.4% of isolates were ESBL producers and 46.9% of them were AmpC producers. Modified Hodge test method identified 63.7% of A. baumannii as carbapenemase producers where as CarbAcineto NP test identified 63% and exibiting 94.74% sensitivity, 93.22% specificity when compared to Modified Hodge test. Conclusion: Multidrug resistant Acinetobacter spp. is on the rise. Present study showed that high percentage of drug resistance in A. baumannii could be due to production of ESBLs, AmpC and carbapenemases. Among all beta lactamases carbapenemase producers are more and quickly raising in A. baumannii. Rapid, cost effective assay which can be adopted in all clinical laboratories is critical to prevent their further transmission particularly in hospital environment.