Human metapneumovirus (hMPV) is recognized as a significant cause of acute respiratory infections among infants under 5 years of age. Nasal swabs collected from January 2021 to June 2024 were screened to detect hMPV using reverse transcription-quantitative polymerase chain reaction. Furthermore, representative positive samples were sequenced and subjected to phylogenetic analysis. Of 4519 samples tested, 113 were positive for hMPV. Notably, an outbreak occurred between November 2022 and March 2023, where 56 of 583 (9.6%) patients tested positive. Analysis of the outbreak samples revealed that majority (6.3%) of cases occurred in December and January. hMPV infection was more prevalent in less than 1 year, with 29 (67%) patients with a history of wheezing and 3 (6.9%) with seizures. On the genetic analysis of F protein, 37 samples identified two genotypes as A and B, with subclusters of 29 (85.29%) samples to A2.1, 1 (2.94%) to A2.2.1, and 4 (11.76%) to A2.2.2 within genotype A and one sample clustered with B1 and 2 samples to B2 within genotype B. The study underscores the significant prevalence and genetic diversity of hMPV in children in Puducherry, India. Notably, the identification of novel A2.2.1 and A2.2.2 lineages highlights the evolving nature of hMPV.

Objective Microbiological confirmation of tuberculosis (TB) in pediatric cases is challenging due to its paucibacillary nature and difficulty in specimen collection. This study aimed to validate stool as an alternative sample for the diagnosis of pediatric pulmonary TB via Xpert MTB/RIF (Xpert) assay. Materials and Methods This cross-sectional study included 75 pediatric patients up to 10 years of age with signs and symptoms suggestive of TB. From each recruited patient, pulmonary and stool samples were collected in a sterile container. The collected samples were subjected to Ziehl-Neelsen staining, BACTEC MGIT 960 culture (MGIT), Xpert, and in-house multiplex polymerase chain reaction for TB diagnosis. Results About 13.33% (10/75) of the pulmonary samples and, of them, 50% (5/75) of the stool samples were positive by Xpert assay. The sensitivity and specificity of Xpert assay with stool and pulmonary samples were 50 (95% confidence interval [CI]: 18.71–81.29%) and 100% (95% CI: 94.48–100%), respectively. Conclusion The Xpert assay on stool samples showed limited sensitivity and good specificity in the diagnosis of pulmonary TB. Therefore, it can be proposed as an alternative screening sample to diagnose TB in pediatric cases for which getting a respiratory sample is extremely difficult. However, further studies with greater number of samples and multiple baseline variables are required to support our findings. Strategies to optimize stool Xpert assay should be performed to enhance the sensitivity of this method to detect Mycobacterium tuberculosis in children.

Edwardsiella tarda is a rare, gram-negative pathogen, often associated with gastrointestinal or soft tissue infections that can cause severe systemic infections, including bacteremia. This case underscores the need for clinical awareness of E. tarda as a potential pathogen in systemic infections.

Background: Mycobacterium abscessus complex (MABC), comprising Mycobacterium abscessus subsp. abscessus (MABa), Mycobacterium abscessus subsp. bolletii (MABb), and Mycobacterium abscessus subsp. massiliense (MABm), is an emerging group of non-tuberculous mycobacteria with clinically significant infections and challenging treatment outcomes due to extensive antimicrobial resistance. Accurate subspecies identification and characterization of resistance- and virulence-associated determinants are essential for effective disease management. This study aimed to determine the prevalence and subspecies distribution of MABC and to characterize resistance-associated mutations and virulence factors, including biofilm formation. Methods: A total of 1110 NTM-suspected clinical samples were screened during the study period, between January 2024 and October 2025. Samples negative by GeneXpert MTB/RIF were subjected to Mycobacteria Growth Indicator Tube (MGIT) culture, followed by Ziehl–Neelsen staining and MPT64 antigen testing. Acid-fast bacilli-positive, MPT64-negative isolates were identified as NTM and analyzed using GenoType CM and NTM-DR line probe assays (LPA) for species identification and detection of resistance-associated mutations. A polymerase chain reaction (PCR) assay was optimized to differentiate MABa and MABm. All MABC clinical strains were further characterized for colony morphology (smooth and rough) and biofilm formation. Three biofilm-producing MABa strains (2 rough and 1 smooth) that were detected as macrolide-resistant by NTM-DR were subjected to whole-genome sequencing (WGS). Results: Among 1110 clinical samples, MABC was identified in 2.25% (n = 25) of cases, while other NTM species accounted for 4.41% (n = 49). Among 25 MABC clinical strains, 14 (56%) were MABm, and 11 (44%) were MABa, as confirmed by both LPA and PCR. LPA-NTM DR detected erm(41) T28 sequevar (n = 9) and C28 mutation (n = 2) among MABa strains, with one strain exhibiting aminoglycoside resistance-associated rrs mutation. Nineteen isolates displayed a smooth morphotype (MABa = 8 and MABm = 11), and six were rough (MABa = 3 and MABm = 3). Biofilm formation was observed in both smooth (n = 5) and rough (n = 4) morphotypes. WGS analysis confirmed erm(41) T28 sequevar, identified a missense mutation (A238G), and revealed genes associated with glycopeptidolipid biosynthesis. Conclusions: Our findings provide important insights into subspecies identification and genetic determinants associated with drug resistance and virulence in MABC. The biofilm-forming ability observed in both smooth and rough morphotypes emphasizes its potential role in persistence and treatment challenges, emphasizing the need for comprehensive diagnostic strategies.

Catheter-related bloodstream infections (CRBSIs) are a major cause of morbidity in patients with chronic kidney disease (CKD) undergoing maintenance hemodialysis. We report the case of a 19-year-old female with bilateral grade IV CKD and end-stage renal disease (ESRD) on hemodialysis via a right internal jugular vein (IJV) catheter, who presented with fever, nausea, and vomiting. Blood cultures obtained from the central line and peripheral vein flagged positive with a 2.5-hour differential time to positivity. Gram staining and culture revealed Gram-negative bacilli, later identified by MALDI-TOF MS as Rhizobium radiobacter, an emerging opportunistic pathogen. Antimicrobial susceptibility testing demonstrated susceptibility to cotrimoxazole, fluoroquinolones, cefepime, meropenem, and minocycline, but resistance to ceftazidime and amikacin. The patient was treated with cefoperazone-sulbactam and catheter removal, following which repeat blood cultures were sterile. R. radiobacter, once considered a contaminant, is increasingly recognized as a true pathogen in immunocompromised hosts with indwelling intravascular devices due to its ability to adhere to silicone surfaces. This case highlights the importance of considering R. radiobacter as a potential cause of CRBSI in hemodialysis patients and emphasizes prompt diagnosis, appropriate antibiotic therapy, and catheter removal as critical components of management.