AM) ,7

EXTENDED SPECTRUM BETA LACTAMASE (ESBL) PRODUCTION AMONG ENTEROBACTERIACEAE IN A TERTIARY CARE CENTRE

Diji Sara Varghese, Shanthi.M., Uma Sekar, Vidhya.M., Arun.V. Dept of Microbiology & Biotechnology, Sri Ramachandra Uni er!ity, "orur, #hennai. Aim $o detect %SB& production among %nterobacteriaceae by phenotypic and genotypic method! in i!olate! obtained from ho!pitali'ed patient! in a tertiary care centre. Ma!eria"s # Me!h$%s (ne hundred clinically !ignificant, non)repetiti e i!olate! of Escherichia coli *+,- and Klebsiella pneumoniae *./- 0hich 0ere re!i!tant to #efota1ime and2 #efta'idime by Di!c Diffu!ion method 0ere included in the !tudy. Minimum 3nhibitory #oncentration *M3#- to #efota1ime *#$4- 0ith and 0ithout #la ulanic acid 0a! determined by Agar dilution method in accordance 0ith #&S3 guideline!. Detection of bla #$4)M gene! 0a! done by "olymera!e #hain Reaction *"#R-. $he i!olate! 0ere obtained from blood *,5-, re!piratory !ecretion! *67- and e1udate! *56-. %SB& !creening and antimicrobial !u!ceptibility to ariou! cla!!e! of antimicrobial! namely Aminoglyco!ide! *Ak-, 8luro9uinolone! *ciproflo1acin-, Betalactam2Betalactama!e 3nhibitor combination! *$'p, #f!- and #arbapenem! 0ere performed by di!c diffu!ion a! per #&S3 guideline!. Res&"!s (f 6:: i!olate! ;, 0ere re!i!tant to #$4, 0ith M3# ranging from , to +6, ug2ml and / i!olate! 0ere !u!ceptible 0ith M3# < , ug2ml . Among the #$4 re!i!tant i!olate!, there 0a! = 7 fold reduction in the M3# 0ith #la ulanic acid. "#R detected the pre!ence of bla #$4)M gene!. All of the i!olate! 0ere !u!ceptible to Aminoglyco!ide! and #arbapenem! and ;,> 0ere !u!ceptible to Beta &actam2Beta &actama!e 3nhibitor combination!. #o)re!itance to 8luro9uinolone! 0a! 5.>. # $'("&si$' ?ide!pread u!e of 7rd generation cephalo!porin! ha! led to the emergence of %SB& of mainly the #$4)M type. @udiciou! u!e of 7rd Aeneration #ephalo!porin! i! to be employed to curtail the !pread of thi! pandemic. AM ) ,.
ISOLATION) PARTIAL PURI*ICATION AND ANTIMICROBIAL ACTIVITY O* BACTERIOCIN PRODUCED BY Lactobacillus plantarum

R+S+Vig'esh,ari) & A.Uma, Dept of Microbiology, #hennai Medical #ollege Bo!pital & Re!earch #entre. $richy)5,6 6:+ Ba(-gr$&'% $he emergence of antimicrobial re!i!tance ha! made !cienti!t! to !earch for no el antibiotic! !uch a! plantaricin) &antibiotic!. "lantaricin i! a bacteriocin produced by Lactobacillus plantarum .O.je(!i/es 0+ To i!olate and partially purify plantaricin from lactobacillu! plantarum ,. $o detect the anti microbial acti ity of plantaricin again!t clinical i!olate! of Aram po!iti e and Aram negati e bacteria, and to pro e that the plantaricin i! pla!mid mediated. Me!h$%s Lactobacillus plantarum 0a! i!olated from Mola!!e! !ample u!ing MRS Agar. "lantaricin produced by thi! !train 0a! purified partially by ammonium !ulfate precipitation follo0ed by dialy!i!. Antimicrobial acti ity of plantaricin 0a! te!ted again!t clinical i!olate! of Staphylococcus aureus, Salmonella typhimurium,E.coli,Klebsiella species and Vibrio cholerae. Anti microbial acti ity 0a! performed by u!ing agar !pot te!t method. 3n thi! method MRS !oft agar 0a! poured o er the BB3 agar plate containing C ml of cell !u!pen!ion of te!t organi!m. $he dialy'ed plantaricin 0a! !potted on to the indicator plate! and incubated for ./ hour!. $he diameter of Done of inhibition greater than ,mm 0a! con!idered a! po!iti e. Res&"!s "lantaricin ga e a highe!t bactericidal acti ity of /mm Done of inhibition for Staphylococcus aureus, E.coli and Cmm for Salmonella typhimurium. $he i!olated "lantaricin 0a! pla!mid)mediated and thu! 0a! pro ed by pla!mid curing. #$'("&si$'s "lantaricin !ho0ed highe!t inhibitory acti ity again!t Aram po!iti e and Aram negati e bacteria !tudied. A! the re!ult! of plantaricin are promi!ing, the role! of lantibiotic! again!t multidrug re!i!tant bacteria need further e1ploration.

AM) ,+ STUDY O* ANTIBIOTIC RESISTANCE O* PSEUDOMONAS AERUGINOSA IN 1OSPITAL IN*ECTION CASES IN MATERNITY 2ARD AND LABOR ROOM *ROM GULBARGA REGION Girish+C+Ma!h., ManEula.F.A., #hannappa.$.Shi anna ar., Subha!hchandra.M.Aaddad. Department of Microbiology, @nana Aanga, Aulbarga Uni er!ity, Aulbarga G +/+6:5
3nfection! are more !e ere in pregnant 0omen and increa!e the ri!k of harm to the fetu! or ne0born. 3nfection! during birth proce!! are !ignificant cau!e of fetal and neonatal mortality and an important contributor to early and later childhood morbidity. Maternity 0ard ha! lot of microorgani!m! that include Pseudomonas, E.coli, Proteus, Staphylococcus, Streptococcus, Enterobacter 0hich degrade fetal membrane. Pseudomonas aeruginosa i! one of the mo!t common pathogen in ol ed in ho!pital infection *B3- cau!ing opportuni!tic infection in human!, particularly among immuno compromi!ed patient!, and becau!e of it! ubi9uitou! nature, ability to !ur i e in ad er!e condition! and affinity for moi!t en ironment! remain a common pathogen in inten!i e care unit! *3#U-. $he obEecti e of the pre!ent !tudy i! the incidence of Pseudomonas aeruginosa in animate and inanimate obEect! and their re!i!tance pattern! from maternity 0ard and labor room from Aulbarga region. $he !tudy 0a! conducted 0ith 6;: !ample! from animate and inanimate obEect! from maternity 0ard and labor room. A total of .7 Pseudomonas aeruginosa *,,.57>- 0ere i!olated and identified by morphological, cultural and con entional biochemical characteri!tic!. All the !tudy i!olate! 0ere !ubEected for antimicrobial !u!ceptibility te!t by Hirby Bauer di!k diffu!ion method u!ing 6. antibiotic!, #arbencicillin *#B6:: mcg, (flo1acin *(8- + mcg, Amikacin *Ak- 7: mcg, A'treonam *A$- 7: mcg, #iproflo1acin *#3"- + mcg, Aentamycin *A%F- 6: mcg, "iperacillin2 ta'obactam *"3$- 6::26:mcg, #efo1itin *#4- 7: mcg, 3mipenem *3"M- 6: mcg, &e oflo1acin *&%- + mcg, Forflo1acin *F4- 6: mcg, #efota1ime *#$4- 7: mcg, #efta'idime *#AD- 7: mcg, #efta'idime2cla ulanic acid *#A#- 7:26: mcg. All the i!olate! 0ere re!i!tant to one or more than one antibiotic, ;:.5:> i!olate! 0ere re!i!tant to a'treonem follo0ed by cefo1itin */6.7:>-, (flo1acin 5,.C> and the lo0e!t number! of i!olate! 0ere re!i!tant to imipenem *67.;: >-. $he incidence of MDR *Multi drug re!i!tance- 0a! found to be ,. *++./6>-.

AM),5
PREVALENCE O* ESBL PRODUCING GRAM3NEGATIVE PAT1OGENS IN DIABETIC *OOT IN*ECTION *ROM C1ENNAI A+S&resh0) A.Muthu6, A.Mo!e!, and R.Sri ani64 6Department of Microbiology, Dr. A&M "A 3BMS, Uni er!ity of Madra!, #hennai. ,Diabetology department, $ertiary care ho!pital & Re!earch, #hennai. O.je(!i/e Diabetic foot infection *D83- i! a common cau!e for the ho!pital admi!!ion! of the diabetic patient! and cau!ed by a number of !ociocultural practice! in 3ndia. $he pre!ent !tudy 0a! undertaken to find out the polymicrobial! from the D8U patient!. Ma!eria"s a'% Me!h$%s 3n our !tudy, 6,7 0ound !0ab! collected from diabetic foot ulcer! of both in)patient! and outpatient! attending diabetic foot clinic in a Hilpauk Medical college, Bo!pital and Re!earch #hennai bet0een ,::C September to ,::/ (ctober. ?ound !0ab! collected and proce!!ed by routine !tandard procedure. Antimicrobial !u!ceptibility and %SB& !creening 0ere carried out for gram)negati e pathogen a! per the #&S3 guideline!. Res&"! a'% ($'("&si$'s (ut of 6C6 i!olate!, our !tudie! 0ere 55)gram po!iti e i!olate!, candida albican! */-, ;C)gram negati e i!olate! it include non)fermenter *.6and %nterobacteriaceae *+5- obtained. &ine'olid and Vancomycin found to be highly !en!iti e to the group e!pecially gram)po!iti e i!olate!. 3n gram negati e #iproflo1acin and $obramycin found better !en!iti ity and cefta'idime !ho0ed higher percentage of re!i!tance by M3#. $he antibiotic combination of #ephota1ime I cla ulanate, #efta'idime I cla ulanate and #efepime I cla ulanate !ho0ed %SB& po!iti ity of 5+.;C> *5.2;C-, *+;.C;>- +/2;C and *,..C.>- ,.2;C re!pecti ely. MB& po!iti ity in both re!i!tant and !en!iti e i!olate of all gram)negati e bacteria include! C7.,6> *.62+5- of %nterobacteriaceae and C:.C7> *,;2.6- of non) %nterobacteriaceae. $hereby 0e conclude that proper diagno!i! of MDR gram negati e producing multiple beta)lactama!e! in routine lab i! nece!!ary follo0ed by Eudiciou! u!age of antibiotic! and multi)di!ciplinary approach can be the optimum therapy for the life threatening diabetic foot ulcer

AM) ,C
RESISTANCE PATTERN O* BACTERIAL PAT1OGENS IN A TERTIARY CARE MULTIDISCIPLINARY INTENSIVE CARE UNIT S.@aya pra!anthi , M. Shanthi ,Uma S!kar,A.S.Arunkumar, Dept. of Microbiology & Dept. of critical care, Sri Ramachandra Uni er!ity, "orur, #hennai. O.je(!i/e $o e aluate the antibiotic re!i!tance pattern! of i!olate! from patient! admitted in 3#U for more than ./hr!. Ma!eria"s # Me!h$%s #linically !ignificant, non repetiti e i!olate! from clinical !pecimen! of icu patient! obtained from Euly ,:6: to december ,:6: 0ere analy'ed. they 0ere identified upto !pecie! le el by con entional or automated method! . the !ource of the i!olate! 0ere re!piratory *76.,>-, blood *,6.7>-, urine *,..,>- and e1udate! *,7.6>-. Antimicrobial !u!ceptibility te!t! 0ere performed to different cla!!e! of antibiotic! a! per #&S3 guideline!. Res&"!s (f ;+6 !pecimen!, !ignificant gro0th occurred in 75.7 >, yielding 7.5 organi!m!. $hey 0ere gram negati e bacilli *C/.;>- compri!ing A cinetobacter sp. *,,.,>-, "seudomonas sp. *6+.5>- and %nterobacteriaecea *.6>-. other! 0ere #andida sp *6C.7>-, Staphylococci * 66.;> - and %nterococci *;.,>-. Among %nterobacteriaecea /7.6% were %SB& producer!. $hey 0ere co re!i!tant to fluoro9uinolone! *5:.+>-, aminoglyco!ide! *+/..>-, betalactam 2betalactama!e inhibitor! re!i!tance rate! 0ere piperacillin)ta'obactam *.:.6.>- and cefpera'one)!ulbactam *,,.+7>-. Re!i!tance to carbapenem! 0a! ob!er ed in 6/.7>. Re!i!tance to imipenem 0a! 5:> and 7C> in Acinetobacter and "!eudomona! sp. respectively. Re!i!tance to bl/bli was more in cinetobacter sp. *5:>than in p!eudomona! sp *!!%". #esistance to polymy$in b was not observed in pseudomonas sp. 0hile in cinetobacter sp it 0a! %.&%. (f the %nterococci sp. /.> e1hibited high le el gentamycin re!i!tance. Among Staphylococci ,..7 > 0ere coagula!e po!iti e of 0hich +:> 0ere methicillin re!i!tant. # $'("&si$' $he high degree of re!i!tance to ariou! cla!!e! of antimicrobial! among icu pathogen! i! alarming. $hi! call! for implementation of pre enti e and control !trategie! 0hich include! Eudiciou! u!e of antimicrobial! and !trict enforcement of infection control protocol!.

AM),/ P1ENOTYPIC AND GENOTYPIC C1ARACTERI5ATION O* MRSA ISOLATES IN A TERTIARY CARE CENTER+ 6 Tas'eem Ba'&, M.Shanthi,Uma Sekar,Arunagiri.HJ,B.SekarJ Dept of Microbiology, Sri Ramachandra Uni er!ity, "orur,#hennai G 5::665 and J#ental &epro!y $raining and Rea!earch 3n!titute,#hengalapattu,#hennai.
Aim $o characteri'e 66. MRSA *Methicllin Re!i!tant Staphylococcu! Aureu!- i!olate! obtained from ho!pitali'ed patient! i!olated from "u! *5+-, ?ound !0ab *,6-, Blood *,6-, $i!!ue *7-, endotracheal a!piratioe*,-, bronchial 0a!h *6- and knee a!pirate *6-. Me!h$%s Antimicrobial !u!ceptibility te!ting 0a! done by di!c diffu!ion techni9ue a! per #&S3 guideline! for ariou! cla!!e! of antimicrobial! namely beta) lactam!*penicillin! andcephalo!porin!-, Macrolide!, 8luoro9uinolone!, Aminoglyco!ide!, Alycopeptide!, &ipopeptide! and &inco!amide!. Methicillin re!i!tance 0a! !creened by di!c diffu!ion method u!ing (1acillin *6K g- and #efo1itin *7: Kg- di!c!.3nducible #lindamycin re!i!tance 0a! detected by D)te!t..Minimum 3nhibitory #oncentration *M3#- 0a! determined for #efo1itin, $eicoplanin, Vancomycin, Daptomycin and &ine'olid in accordance 0ith #&S3 guideline! u!ing !uitable control!. Detection of "enicillin Binding protein ,a *"B",a- 0a! done u!ing late1 agglutination and mec gene by "olymera!e #hain Reaction *"#R-. Res&"!s All the 66. MRSA i!olate! 0ere re!i!tant to (1acillin.#efo1itin re!i!tance 0a! ;5.+>*nL66:- a! determined by M3# .All the i!olate! 0ere !u!ceptible to Vancomycin,$eicoplanin,Daptomycin and &ine'olid and had M3# 0ithin !u!ceptible range.Re!i!tance to %rythromycin 0a! C,>*nL/,-,#iproflo1acin C;> *nL;:-,Aentamycin 5,.7>*nLC6- and 3nducible #lindamycin re!i!tance 6C.+>*nL,:-,.All the i!olate! e1pre!!ed "B",a and mec gene 0a! detected in /. i!olate! *C7.C>-. C$'("&si$' Detection of MRSA i! important for appropriate treatment of infection! cau!ed by them and for implementing infection control practice! to pre ent their di!!emination.