Background: Carbapenem-resistant Gram-negative bacteria (CR-GNB) pose a serious global health threat, especially in low- and middle-income countries. Local surveillance is crucial for informing antimicrobial stewardship and infection control strategies. This study aimed to evaluate the prevalence, demographic distribution, and temporal fluctuations of carbapenem resistance among key Gram-negative pathogens in a South Indian tertiary care center over a two-year period.Methods: A retrospective study was conducted on 8,359 non-duplicate Gram-negative isolates obtained from clinical specimens between July 2022 and July 2024. Organisms were identified, and antimicrobial susceptibility was determined using the VITEK^® 2 Compact system (BioMérieux). Resistance to imipenem (IPM) and meropenem (MEM) was assessed. Data were stratified by age, sex, ward type, specimen source, and quarterly distribution. A subset of resistant isolates underwent molecular screening for carbapenemase genes using real time PCR.Results: Carbapenem resistance was observed in 24% (2007) of Gram-negative isolates. Acinetobacter baumannii (48.0%) and Klebsiella pneumoniae (38.6%) accounted for the majority of resistant cases. Resistance was significantly higher in males (64.3%) and in patients aged 61–80 years (p < 0.001). Surgical wards showed greater resistance rates compared to medical departments. A peak in resistance was identified during January–March 2023, particularly for A. baumannii (76.3%). IPM-MEM resistance discrepancies were found in Citrobacter and Proteus species. Gene profiling of resistant strains revealed the predominance of bla_NDM, bla_VIM in all organism.Conclusion: The findings reveal a high and fluctuating burden of carbapenem resistance, especially in elderly males and surgical settings. Continuous surveillance and targeted interventions are vital to curbing the spread of CR-GNB in high-risk healthcare environments.

Hyperglycemia, a key characteristic of type 2 diabetes mellitus (T2DM), highlights the need for effective management strategies. This study aims to analyze the impact of multistrain probiotic supplementation on glycemic control in T2DM patients. During a 24-week randomized controlled trial involving 130 participants, subjects were assigned to either a probiotic group or a placebo group. The key outcomes included fasting blood glucose (FBG), postprandial blood glucose (PPBG), glycated hemoglobin (HbA1c) levels, and lipid profiles, assessed at baseline and post-intervention. The results indicated a significant reduction in HbA1c (p = 0.004) and increased HDL-c (p = 0.023) and improvements in lipid profiles in the probiotic group, alongside a trend toward decreased FBG and PPBG. No serious adverse effects were reported, indicating good tolerance of probiotics. These findings suggest that probiotics may positively influence metabolic parameters in T2DM patients, supporting their potential as a complementary dietary intervention. Further research is needed to understand the underlying mechanisms and enhance probiotic formulations for diabetic control.

Viridans streptococci are important causative organism of infective endocarditis, which is a disease having long-lasting effects among the patients who live with the disease as well as those who are cured. Infective endocarditis due to viridans streptococci generally usually affects persons with structural heart disease and is also associated with intravascular prosthetic devices. After the onset of bacteremia with the pathogenic viridans streptococci, vegetation is formed in one or more heart valves. The diagnosis of infective endocarditis due to viridans streptococci is difficult to establish in patients with underlying risk factors and it involves the correlation of microbiological (in-vitro growth of viridans streptococci), clinical, and echocardiography results (modified Duke criteria). The common microorganisms are Staphylococcus spp., Enterococcus spp followed by viridans streptococci. The details of viridans streptococci causing infective endocarditis were reviewed in detail. Viridans streptococci possess a challenge in identification up to its species level and which helps in the identification of the source of infection as well as treating the infection.

Candida spp. is one among the major causes of nosocomial infection, with candidemia gaining increasing prevalence worldwide in parallel with mortality rates ranging from 10-49%. Epidemiology and predisposing factors of candidemia have changed since the number of patients receiving transplants and immunosuppressive therapy, the use of broadspectrum antimicrobials, and the number of AIDS patients have increased. Candidemia is more common among patients with subcutaneous and cutaneous candida infections, through percutaneous inoculation. Major predisposing factors for invasive candidiasis includes neutropenia, haematological malignancies, bone marrow transplantation, total parenteral nutrition, chemotherapy, invasive procedures, and immune-suppressive agents. This study analyses the risk factors of immunocompromised patients with candidemia and antibiogram of Candida spp. isolated from ICU patients. To evaluate the prevalence, distribution and antibiogram of Candida spp., associated risk factors, and outcome in candidemia patients. Blood samples received from patients with clinically suspected fungal infections were subjected to gram staining, culture, sugar assimilation & fermentation, Candida Chrome agar (CCA) & Corn meal agar for identification and speciation. Antifungal susceptibility tests were performed by disk-diffusion tests. Among a total of 337 samples received, 22 (6.5%) samples were positive for candida infections, of which Candida tropicalis 9 (41%) was the predominant isolate followed by C. albicans 5 (23%), Candida glabrata 4 (18%), Candida parapsilosis 2 (9%) and Candida krusei 2 (9%). Male patients had a higher prevalence of candidemia 15 (68.2%). Among the age group of 51-70 years, uncontrolled DM(Diabetes mellitus) and CKD (chronic kidney disease) were found to be the predominant co-morbidities with candidemia.

Skin and soft tissue infections (SSTIs) are the most common type of infection globally and also in India. Periodic evaluation of data on microbial profiling and antibiogram trend analysis is mandatory for creating a timely empirical treatment guideline and a proper antimicrobial cycling plan. In the current study, retrospective analysis of the data from 3,570 samples collected from suspected SSTI over one year was performed. Analysis was done on the clinical condition, causative agent/s identified and their antimicrobial susceptibility according to the standard guidelines. Seventy-three percent of samples yielded positive growth, with majority being unimicrobial infections. Gram-negative bacteria (GNB) were more commonly associated with infections from in-patients while Gram-positive cocci (GPC) were seen among out-patients. More than 70% of isolates among GNB were found susceptible to Carbapenems, piperacillin-tazobactam, amikacin and chloramphenicol. Among GPC, maximum sensitivity was seen to glycopeptides, linezolid followed by chloramphenicol, tetracycline, clindamycin and amikacin. Unusual resistance patterns like Penicillin resistant Ampicillin sensitive Enterococcus faecalis (PRASEF)strains, Multidrug resistance (MDR) and Extended drug resistance (XDR) were higher among Enterococci spp, MRSA, Acinetobacter spp and Klebsiella spp. Resistance to penicillin and cephalosporin drugs were high among GNB and GPC. Carbapenems, aminoglycosides, glycopeptides and broad-spectrum antibiotics are found sensitive and potential choices for empirical therapy. As prevalence of MDR and XDR strains were high and the trend analysis shows likelihood of few of the first and second line drugs becoming sensitive in future, we conclude that continued analysis of bacterial profiling and AMR pattern analysis among SSTI is essential.