Indian Journal of Medical Microbiology
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Item Audit for antifungal treatment usage in adults with invasive fungal infection: A prospective observational study(Indian Association of Medical Microbiologists, 2025-02) A., Gupta; I., Xess; M., Soneja; V.C., Keri; K., Sikka; V., Siddharth; J., Sachdev; R.M., Pandey; A., Kumar; N., Wig; G., SinghObjective: The antifungal audit aimed to evaluate antifungal usage in a tertiary care center. It focused on patient profiles, the appropriateness of antifungal use, associated adverse drug reactions, reasons for suboptimal usage, and the economic burden caused by prolonged non-optimal antifungal use. Methodology: Conducted at All India Institute of Medical Sciences, New Delhi, India from January 2019 to December 2020, the study evaluated systemic antifungal use in 100 hospitalized adults with invasive fungal infections. Data collected included patient characteristics, evidence of disease, antifungal agents used, drug ADRs, appropriateness, and economic impact. Antifungal use was assessed using a predefined score (score <10 considered non-optimal), and ideal therapy duration was calculated based on treatment guidelines (IDSA & ECIL). Results: Optimal antifungal use was observed in 66.0 % of cases. Common reasons for non-optimal use included alternate drug selection (18 %), inappropriate dosage (12 %), lack of adjustment after microbiological results (14 %), and incorrect therapy duration (16 %). Targeted antifungal therapy was observed in 39 out of 100 patients, while pre-emptive antifungal therapy was used in 32 out of 100 patients. Voriconazole (35.1 %), caspofungin (23.1 %), and liposomal amphotericin B (20.1 %) were commonly prescribed. Liposomal amphotericin B had the highest adverse reaction rate (81.4 %). The total cost of antifungal therapy for 100 patients was ?67,06,840 (approximately 80,350 $), with non-optimal prolonged therapy leading to an additional economic burden of ?1,149,191 (approximately 13,841 $). Overall, 748 (39.7 %) day of therapy were non-optimal, contributing to 17.1 % of the total cost of antifungal therapy. Conclusion: We observed non-optimal use of antifungal agents in 34 % of the study participants. The study results show that the antifungal audit enhances stewardship by pinpointing causes of non-optimal use, ensuring adherence to prescribing standards, optimizing clinical outcomes, and minimizing drug-related toxicities in tertiary care centres.Item In vitro efficacy of levonadifloxacin against methicillin-resistant Staphylococcus aureus (MRSA) including hVISA isolates collected across India(Indian Association of Medical Microbiologists, 2025-02) S., Vinayan; S., Sistla; M., Manoharan; K., walia; M., SugumarBackground: Vancomycin has been the preferred treatment for MRSA infections. However, newer drugs are necessary due to the increasing prevalence of MRSA isolates that are less susceptible to vancomycin. Levonadifloxacin and its prodrug alalevonadifloxacin, novel quinolones with broad spectrum anti-MRSA activity. They are approved in India for the treatment of skin and soft-tissue infections, bacteraemia, and diabetic foot infections. Materials and methods: A total of 456 MRSA (Methicillin-resistant Staphylococcus aureus) isolates, including 333 isolates from JIPMER and 123 isolates from other tertiary care centers collected between January to December 2022, underwent susceptibility testing to levonadifloxacin by disc diffusion method. The study isolates included 29 h-VISA. Fifty one blood isolates were also subjected to E-test and their results were compared to the gold standard, broth micro dilution (BMD). Result: All 456 isolates were found to be susceptible to levonadifloxacin by disc diffusion. Levonadifloxacin demonstrated potent activity against MRSA strains isolated from blood (n = 51) with an MIC50 and MIC90 of 0.38 and 0.5 ?g/mL by E-test, respectively. Similarly, it demonstrated an MIC50 and MIC90 of 0.5 & 1 ?g/ml by BMD. Conclusion: The present study demonstrated 100 % susceptibility to levonadifloxacin among the tested isolates of MRSA, highlighting its promising clinical potential for treating infections caused by this organism. Furthermore, the study recorded a concordance of 100 % between disc diffusion and Etest method with BMD, indicating the reliability of these methods.Item Ralstonia pickettii bacteremia: A retrospective review of records(Indian Association of Medical Microbiologists, 2025-02) A., Sebastian; N., Gupta; B., Banerjee; K.E., Vandana; C., Mukhopadhyay; T., Praveen Kumar; M., VarmaIntroduction: Ralstonia pickettii is a non-fermenting gram-negative bacillus rarely associated with hospitalacquired infections. The study aimed to characterise the clinical profile and outcomes of R. pickettii bacteremia cases. Methodology: We retrospectively reviewed the hospital records to collect the details of the clinical profile and outcomes of patients with R. pickettii bacteremia between March and November 2021. Results: Twenty-four patients were found to have Ralstonia pickettii bacteremia between March and May 2021. The cases were distributed across the hospital. All isolates were found to have similar antimicrobial susceptibility. The same organism with similar susceptibility was found to be in distilled water used to prepare in-house disinfectant and antiseptic agents. Commercial preparations replaced in-house solutions all over the hospital as a corrective measure. The distilled water tank was renovated, and repeat samples were found to be satisfactory. There were no further reports of Ralstonia pickettii between May and November 2021. Conclusion: We report this to highlight the possibility of infection with this rare pathogen and to increase awareness of the importance of appropriate infection control measuresItem Molecular analysis of acute hemorrhagic conjunctivitis in a tertiary care hospital, Kalburgi district, Karnataka 2023(Indian Association of Medical Microbiologists, 2025-02) J.N., Sanganal; A., Shinde; M.I., Ahmed; S.A., Pattassery; S., Subash; S., Vilasagaram; P., Kumar; M., Narayana; A., MunivenkatappaIntroduction: Viral infections are the predominant cause of acute hemorrhagic conjunctivitis (AHC) across the globe. From July to August of 2023, a large-scale conjunctivitis outbreak was witnessed in India, affecting a large number of individuals. The present study was initiated to identify the causative agent responsible for the AHC outbreak in Kalburgi district of Karnataka state. Methodology: Conjunctival and throat swabs were collected from AHC patients from a tertiary care hospital in Kalburgi from August to September 2023. After total viral RNA extraction from all the samples, reverse transcriptase PCR was performed using 5? non-coding regions of the enterovirus (EV) genome. The positive samples were further subjected to PCR using EV type-specific primers of Coxsackie A-24 variant (CA24v) and enterovirus70 (EV-70). EV negative samples were also tested for human adenovirus. Five representative CA24v-positive samples were subjected to partial sequencing and phylogenetic analysis. Results: Thirty-three AHC patient samples were included in the testing and analysis. EV was detected among 54.5 % (18/33) of the patients and all were found to be CA24v, while no EV-70 or human adenovirus was detected. Partial 3C-proteinase sequencing revealed that the CA24v strains from Kalburgi were closely clustered and had 99 % sequence identity with CA24v strains reported from China in 2023. However, the Kalburagi strains were 90.3–93.2 % identical to previously reported Indian strains. Conclusion: To summarize, CA24v was identified as an etiological agent responsible for the recent acute hemorrhagic conjunctivitis outbreak in Kalburgi. The CA24v strain detected was closely related to the currently circulating Asian strains.Item Mycoplasma pneumoniae among children hospitalized in a tertiary hospital with community-acquired lower respiratory tract infections(Indian Association of Medical Microbiologists, 2025-02) S., Kumar; S.R., Saigal; S., Kumar; G.R., SethiPurpose: In this prospective study incidence of Mycoplasma pneumoniae (M. pneumoniae) infection was investigated in children with community-aquired lower respiratory tract infections (LRTIs) using methods such as serology, nested PCR (polymerase chain reaction), and multiplex PCR analysis. Methods: M. pneumoniae infection was investigated among 200 children with LRTIs, ages 2 months to 12 years,. Blood samples were taken for M. pneumoniae antibodies both during admission and four to six weeks following enrollment. Nested and multiplex PCR analysis was performed to identify M. pneumoniae from nasopharyngeal aspirates (NPAs). Results: Infection due to M. pneumoniae was noted in 29 children (74.35 %) < 5 years of age and in 10 children (25.65 %) aged ?5 years. The relationship between M. pneumoniae and age was statistically significant in the age group of children under five years [P = 0.004]. No statistically significant difference was seen between male and female children [P = 0.91]. Clinical and radiological results and M pneumoniae infection did not demonstrate any statistically significant correlation with the exception of the presence of statistically significant infiltrates (P = 0.04). In 39 (19.5 %) children, M. pneumoniae was found using a combination of multiplex PCR, nested PCR, and serology. Serology sensitivity was 66.67 %, specificity was 88.56 %, positive and negative predictive values were 36.36 % and 96.41 %, respectively, when using nested PCR as the diagnostic criteria. Conclusions: In summary, our research established the critical role of M. pneumoniae infection in communityacquired LRTIs in children particularly in children under five years. There was an association between wheezing and acute M. pneumoniae infection. Multiplex PCR, nested PCR, and serology are used in conjunction to help diagnose M. pneumoniae infection in children with community-acquired LRTIs.Item A case of Vibrio pelagius in a child with inflammatory bowel disease(Indian Association of Medical Microbiologists, 2025-02) A.R., Mohan; P.S., Balaji; N., Lakra; R.S., Rangan; T., Selvan; J., MandalWe describe a rare case of an eleven-year-old child with undiagnosed underlying Crohn’s disease who contracted Vibrio pelagius. Though the exact source remained undetermined, the child may have acquired it through infected sea food. Automated system failed to exactly identify the isolated organism; we used detailed biochemical tests for identification. Early diagnosis and identification allowed for efficient treatment plan and the clinical improvement of the child. This case report will give insight to clinical microbiologists for identifying such uncommon bacteria by using biochemical assays in addition to automated systems especially, in those with underlying bowel illnesses.Item Pattern of rapidly growing mycobacteria (RGM) species isolated from clinical samples: A 10-year retrospective study in a tertiary care hospital of Bangladesh(Indian Association of Medical Microbiologists, 2025-02) L., Barai; M.R., Saha; T., Rahman; M., Sukanya; J., Ferdous; A., Khanduker; R., Hasan; T., NovaPurpose: Infections caused by rapidly growing mycobacteria (RGM) are increasing worldwide. The study was conducted in a microbiological laboratory of Bangladesh to determine the pattern of detection of RGM from clinical samples. Methods: All laboratory culture records of RGM from 2012 to 2022 were collected retrospectively and analyzed. Results: A total 62 RGM infected patients with surgical site infection (74.1 %), injection site and skin abscess (9.7 %), septicaemia (4.8 %) and UTI (1.6 %) were identified. The annual isolation frequency of RGM increased 4.8 %–29.1 % in between year 2012 and 2022. RGM infected patients (14.5 %) were mistakenly treated with first line anti tubercular drug before correct microbiological diagnosis (median, IQR; 3, 2–5 months). Out of 23 RGM isolates, 86.9 % were M. abscessus and rest 13.1 % were M. fortuitum. Most of them (?95 %) were sensitive to amikacin, linezolid, clarithromycin where as 27.1 % to imipenem and ciprofloxacin, 40 % to cefoxitin, 35.3 % and 1.7 % to doxycycline and co-trimoxazole respectively. Conclusion: Misdiagnosis or delay in diagnosis and erroneous treatment with first line anti tubercular drug may cause prolong morbidity and therapeutic failure to patients with RGM infection. So, early and appropriate diagnosis is crucial for successful outcomeItem Predictive value of Ig Mycoplasma pneumoniae-DNA, high-density lipoprotein, natural killer cell, and platelet levels for diagnosing severe M. pneumoniae pneumonia in children(Indian Association of Medical Microbiologists, 2025-02) Z., Kai-jing; Z., Xin-feng; L., Xiaojuan; H., Xiao-HuiObjective: The present study aimed to assess the predictive value of Ig Mycoplasma pneumoniae (MP)-DNA, highdensity lipoprotein (HDL), natural killer (NK) cell, and platelet (PLT) levels for the diagnosis of severe MP pneumonia (SMPP) in children with MP pneumonia (MPP). Methods: Children with MPP admitted to our hospital from August 2022 to February 2024 were selected and assigned to the non-SMPP (NSMPP) and SMPP groups according to whether they had severe pneumonia. The following parameters were analyzed and compared between the two groups by the rank-sum test: age; Ig MPDNA level; white blood cell, neutrophil (N), and monocyte counts; platelet (PLT), C-reactive protein (CRP), lactate dehydrogenase (LDH), triglycerides, high-density lipoprotein (HDL), low-density lipoprotein, and procalcitonin levels; and levels of T cells, CD4+ T cells, CD8+ T cells, B cells, and NK cells. The chi-square test was used to analyze differences in these variables between genders. One-way analysis of variance was used to select significant variables (P < 0.1) from the abovementioned ones, and the selected variables were analyzed by multivariate analysis of variance to detect independent risk factors. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) value were determined for the independent risk factors. Results: The two groups showed significant differences in the levels of Ig MP-DNA, N, PLT, CRP, LDH, HDL, CD8+ T cells, and NK cells. PLT and Ig MP-DNA levels were positively correlated with the risk of SMPP development; however, HDL and NK levels showed a negative correlation. The AUC values for Ig MP-DNA + HDL, Ig MP-DNA + NK, Ig MP-DNA + PLT, NK + HDL, NK + PLT, and PLT + HDL were 0.825, 0.812, 0.813, 0.724, 0.717, and 0.701, respectively. Conclusion: The combination of variables, including Ig MP-DNA + HDL, Ig MP-DNA + NK, and Ig MP-DNA + PLT, can predict whether MPP children would develop SMPP.Item The Wolf in Sheep’s Clothing: Incidental Pulmonary Hydatidosis masquerading as Constitutional Symptoms(Indian Association of Medical Microbiologists, 2025-02) D., Biswal; S., Shenoy M; B., C; U., Sureshkumar; V., Acharya K; M., Kamath M; S., BaligaHydatid disease, caused by Echinococcus granulosus, remains a significant health concern in endemic regions. This case report aims to highlight the diagnostic challenges of pulmonary hydatid cysts in non-endemic areas, presenting a unique case of an incidental pulmonary hydatid cyst in a 31-year-old lactating female discovered during evaluation of non-specific constitutional symptoms.Item Triple soil transmitted helminths in a case of aluminium phosphide poisoning(Indian Association of Medical Microbiologists, 2025-02) A., Mewara; M., Thakur; S., Afreen; N., Sharma; S., KhuranaSoil transmitted helminth (STH) infections remain prevalent in India despite the ongoing deworming program. Here, we report a case of triple infection of Ascaris lumbricoides, Ancylostoma duodenale, and Strongyloides stercoralis, in a young asymptomatic and apparently immunocompetent female presenting with aluminium phosphide poisoning. Except for severe anaemia, the only other indicators of chronic infection were occasional abdominal pain and self-limiting loose stools. She was successfully treated for her conditions. This case highlights that despite regular deworming programs in children, STH may continue to infect adults in endemic areas and may be relevant to their well-beingItem A rare case report of Listeria ivanovii bacteremia in an elderly patient with uncontrolled diabetes and chronic kidney disease from South India(Indian Association of Medical Microbiologists, 2025-02) S., Mani; L., Shanmugam; A., Boppe; V., G.We report a rare case of Listeria ivanovii in elderly immunocompromised man with chronic kidney disease from South India, which was identified by conventional methods as well as MALDI-TOF and confirmed with 16S rRNA sequencing. In addition, literature search was done and the 10 cases of Listeria ivanovii infections reported earlier were discussed.Item Comparison of intra-assay and inter-assay reproducibility and positive detection times of two different (BacT/Alert 3D and Autobio BC) commercial blood culture systems(Indian Association of Medical Microbiologists, 2025-02) Kansak, Nilgün; Kalender, Nilay, Zeynep; Ar?c?, Neslihan; Adaleti, R?za; Aksaray, Sebahat; Ankaral?, Handan; Gonüllü, NevriyePurpose: In our study, we aimed to compare the performance of the BacT/Alert 3D (bioMerieux, France) system, which is currently used in our laboratory, and the Autobio BC (Autobio, China) system, which was newly introduced in our country, using standard and clinical isolates. Methods: Bacterial suspension was prepared by two technicians on the same day and three consecutive days from five different standard strains with 0.5 McFarland turbidity, then serial dilution to a final concentration was adjusted and was simultaneously inoculated in aerobic blood culture bottles. The bacterial concentration was measured by making a quantitative counting plate. The same procedure was also performed for 55 clinical isolates belonging to eleven species. After simulated bacteremia with standard and clinical isolates, the growth results were confirmed by inoculation from positive blood culture bottles onto solid medium and identification was made in the next day with MALDI-TOF MS (bioM´erieux). In each study, sterile saline and blood was inoculated into the bottles as a negative control to check contamination. Intra-assay and inter-assay reproducibility of recovery rates and detection times of standard strains; recovery rates and detection times of clinical isolates were compared for both systems. Results: Recovery rates were 100 % in both systems, and when positive detection times were compared, it was found that there was no difference between the two devices in clinical isolates (p:0.262) but that Autobio BC gave significantly (p < 0.001) earlier results in standard strains. Conclusions: In our simulated bloodstream infection study, Autobio BC was found to be comparable with BacT/ Alert 3D, both recovery rates and growth detection time performance were found to be very good, and it can be used in routine microbiology laboratories.Item Digital gangrene without sclerodactyly in the presence of anticentromere antibodies: A unique presentation of scleroderma(Indian Association of Medical Microbiologists, 2025-02) U., Suman; L., Sheoran; V., Manchanda; S., SaxenaPeripheral vascular disorders associated with anti-centromere antibody (ACA) present generally with sclerodactyly in connective tissue disorders (CTD). It is unusual for ACA-associated digital necrosis to develop without preexisting raynaud’s phenomena or vascular risk factors. We report a novel case of a 60-year-old nonsmoker, non-diabetic woman with ACA and isolated finger necrosis without any other features of CTD. This case underscores the importance of considering an autoimmune contribution to the development of digital necrosis even without any identifiable CTD. It highlights the need to consider ACA-associated digital gangrene to be considered as a distinct entity of an autoimmune disorder from scleroderma.Item Fungal nasal polyposis – A rare case report(Indian Association of Medical Microbiologists, 2025-02) J.R., Jeyaraaj; L., Ragunathan; K., Kanniyan; P., Subramanian; S., Shebeena; M., Asarudeen; J.R., RobinAspergillus peyronelii is an emerging and rare pathogen causing chronic rhinosinusitis with fungal nasal polyposis among immunocompetent individuals. Usual fungal aetiologies are Aspergillus spp, Mucor spp and Cladosporium spp, among which Aspergillus flavus being the most common in India. We present a case of 28-year-old woman with unilateral nasal obstruction with 15 years history of allergy, diagnosed as nasal polyposis, uncovered an uncommon pathogen A.peyronelii. Being a saprophytic and endophytic fungus, meticulously diagnostic approaches were employed for the precise identification. Further researches are needed to optimize diagnostic strategies and therapeutic intervention of this species.Item MALDI - TOF MS for the identification of obligate anaerobes and metronidazole susceptibility of anaerobic Gram negative bacilli(Indian Association of Medical Microbiologists, 2025-02) S., D; D., Gounassegarane; R., BiswasMALDI-TOF MS, though has facilitated rapid and accurate anaerobe identification, the problem of rising metronidazole resistance amongst the members of Bacteroides fragilis group is cause for concern. In this one-year study period,152 anaerobic Gram negative bacilli and 60 Gram positive anaerobes were isolated from 167 samples obtained from clinically suspected anaerobic infections. Bacteroides fragilis accounted for 56 % of the total anaerobic GNB and Peptoniphilus asacchrarolyticus was the most commonly isolated Gram positive cocci. All isolates were identified by the MALDI–TOF MS except one isolate each of Clostridium and Peptostreptococcus. Etest for members of Bacteroides fragilis group, demonstrated 26.8 % metronidazole resistance.Item Effectiveness of rotavirus vaccine following introduction in the childhood immunization program in Northeast India(Indian Association of Medical Microbiologists, 2025-02) T.B., Devi; H.R., Singh; C.S., Singh; K.R., Devi; S., LaishramBackground: Rotavirus diarrhoea is a major cause of mortality and morbidity in children under five years of age. The WHO has recommended vaccination against this agent especially in countries with high mortality rates. As India accounts for almost a quarter of worldwide rotaviral diarrhoea cases, the government has introduced indigenously manufactured vaccines in the national immunization schedule which has been implemented in four phases. This study was conducted to assess the effectiveness of the vaccine used in the national immunization program in the state of Manipur in North-east India. Methods: A test negative study design was used comparing rotavirus positive diarrhoeal children to rotavirus negative diarrhoeal children. All children ?5 years presenting with acute diarrhoea were enrolled in the study and antigen detection enzyme-immuno assay was done to detect presence of rotavirus. All rotavirus positive patients were taken as cases and compared with rotavirus negative controls. Results: 63 rotavirus positive cases and 121 rotavirus negative controls were enrolled in the study. Vaccination rate among cases was significantly lower than controls (31.7 % vs 68.6 %, p < .001). Vaccine effectiveness of completed vaccination series was found to be 94 % against rotaviral infection and 98.1 % against severe disease and need for hospitalization. Conclusion: Current rotaviral vaccine used in the national immunization schedule of India is effective in preventing rotaviral diarrhoea in the state of Manipur. Sustained vaccination will reduce the mortality and morbidity of rotaviral diarrhoea in this regionItem Identification of Dengue virus serotype and genotype: A comprehensive study from AIIMS Patna, Bihar(Indian Association of Medical Microbiologists, 2025-02) K., Singh; M.Z., Farooque; V.P., Gandhi; Apurva; A., Kumar; A., Sarfraz; B.K., PatiPurpose: Dengue virus, a major global health concern, exhibits significant genetic diversity, leading to distinct serotypes and genotypes. Dengue is the second most common disease spread by mosquitoes that infect humans, after malaria. In recent decades, there has also been a shift in the tendencies of virus transmission from urban to peri-urban and rural settings. This research study focuses on the identification and characterization of dengue virus serotypes and genotypes. Methods: In this study, specimens collected in one year were first subjected to serological assay (NS1 and IgM) and subsequently the NS1 positive samples were subjected to identification and characterization of the prevalent dengue virus serotypes and genotypes. Results: During the year 2021, a total of 933serum samples were tested, out of which 75 were found positive for NS1 antigen and 135 were positive for Dengue IgM antibody by ELISA. The dengue serotype specific Real-Time RT-PCR Assay detected all four serotypes in the NS1-positive samples, indicating their presence in this region. Of these, DEN-1 was detected in 4 (7.8 %), DEN-2 in 26 (50.9 %), DEN-3 in 20 (39 %), DEN-4 in 1 (1.9 %). Out of 51Real-Time RT-PCR positive samples, 33 were found positive by conventional PCR for genotyping by targeting the capsid-preMembrane (C-prM)region. The genotyping result showed that DENV-1 serotype clustering with GIII, DEN-2 serotype clustering withwide range of genotypes such as IVa, IVb, and IVc, DEN-3 clustering with GIII genotype and DEN-4 serotype showed GIII genotype. Conclusions: This study provides the recent details about the circulating serotypes along with prevalent genotypes in this region.Item CRISPR-Cas-assisted phage engineering for personalized antibacterial treatments(Indian Association of Medical Microbiologists, 2025-02) N., Chaudhary; K., Sharma; H., Kaur; S., Prajapati; B., Mohan; N., TanejaBackground: In the age of modern medicine, CRISPR-Cas system-aided phage engineering has emerged as a major game changer for developing personalized antibacterial treatments. Modifying genomic DNA at a specific location leads to the inactivation of target genes, the acquisition of novel genetic features, and the correction of lethal gene mutations. Phages can be modified to precisely detect and control bacteria because of the vast possibilities of CRISPR-Cas-based genetic engineering. Objectives: The primary objective of this review is to explore the basic principles, mechanisms, limitations, and perspectives of CRISPR-Cas system-aided phage engineering in producing tailored antibacterial therapeutics. Furthermore, this study will address how editing phage genomes using CRISPR-Cas technology allows for precise bacteria targeting, broadening phage host range, and improving infection control tactics. Content: The arrival of the CRISPR-Cas system has transformed the field of phage engineering and aided in the precise modification of phag? genomes to broaden the phage host range. This novel strategy uses the accuracy of the CRISPR-Cas system to design engineered bacteriophages, giving targeted options for infection control. These recent advancements have the potential to alter the era of modern medicine.Item Skin colonization by pathogenic bacteria as a risk factor for neonatal sepsis(Indian Association of Medical Microbiologists, 2025-02) R., Pandey; V., Gupta; S., Jain; N., GulatiBackground: Neonatal sepsis continues to be a leading cause of mortality among the NICU admitted neonates. The most common causative organisms have been proven to be hospital-acquired organisms. Aims and objectives: This study was planned with aim of understanding the pathological colonization of neonatal skin and associated risk factors as well as finding a possible correlation between blood culture isolates and neonatal skin colonizers and their antimicrobial resistance patterns. Methods: This prospective cohort study was conducted at a tertiary care centre in Northern India from January 2021 to June 2022. The study participants were 50 pre-term neonates and 50 term neonates, who were born in our hospital and subsequently admitted to the NICU. Skin swabs, taken from 5 body sites within 24 h of birth and at discharge, were cultured for isolation of pathological bacteria. Neonates were followed-up during their hospital stay for observing any occurrence of blood culture positive sepsis. Results: Out of 100 neonates, 31 pre-term and 28 term neonates were colonized within 24 h of birth while almost all were colonized by discharge. Posterior auricular fossa was the most colonized site. Coagulase Negative Staphylococcus (n = 195) and Escherichia coli (n = 51) were the most common isolates. Risk factors found to be significantly associated with colonization were low birth weight (<2500g), premature rupture of membranes (PROM), invasive mechanical ventilation and positive urine and vaginal cultures of mothers. Neonates with culture positive sepsis also had colonization with MDROs. Conclusions: Neonatal skin colonization and their antimicrobial resistance rates increased over the course of hospital stay, having a possible contribution towards culture positive sepsis.Item Asymptomatic SARS-COV-2 carriage and sero-positivity in high risk contacts of COVID-19 cases’(Indian Association of Medical Microbiologists, 2022-06) Das, Ayan Kumar; Chandra, Kailash; Dudeja, Mridu; Aalam, Mohd KhursheedPurpose: Identifying asymptomatic SARS-COV-2 carriage is one of the crucial factors in controlling the COVID 19 pandemic. The relationship between the asymptomatic viral carriage and the rate of seroconversion needs better understanding. The present study was conducted to identify the asymptomatic COVID-19 infection and seropositivity in high-risk contacts in the southern district of Delhi, India. Methods: Following the screening of 6961 subjects, a total of 407 asymptomatic high-risk subjects were selected. Demographic data, socioeconomic status, and history of COVID-19 related symptoms in the last 4 months were recorded. Blood samples and Nasopharyngeal/oropharyngeal swabs were collected for the detection of SARSCOV-2 RNA and anti-SARS-COV-2 antibodies. Results: 55 asymptomatic high-risk subjects (13.5%) tested positive for SARS-COV-2 infection and among them, 70.9% remained asymptomatic throughout their course of infection. The seropositivity among the subjects was 28.9% (n ¼ 118) and was found significantly higher among lower-middle socioeconomic strata (p ¼ 0.01). The antibody levels were significantly higher (p ¼ 0.033) in individuals with a previous history of COVID-19 like symptoms as compared to the subjects, who had no such history. Asymptomatic healthcare workers showed a significantly increased rate of SARS-COV-2 infection (p ¼ 0.004) and seropositivity (p ¼ 0.005) as compared to the non-healthcare workers. Subjects, who were exposed to infection at their workplace (non-hospital setting) had the least RT-PCR positivity rate (p ¼ 0.03). Conclusions: A large proportion of SARS-COV-2 infection remains completely asymptomatic. The rate of asymptomatic carriage and seropositivity is significantly higher in healthcare workers as compared to the general population. The level of SARS-COV-2 antibodies is directly related to the appearance of symptoms. These observations may contribute to redefining COVID 19 screening, infection control, and professional health practice strategies.