In vitro activity of zidebactam/cefepime (WCK 5222), a β-lactam enhancer/ β-lactam combination against carbapenem- and colistin-resistant Klebsiella pneumoniae isolates.

Objectives: In vitro activity of β-lactam enhancer/β-lactam combination zidebactam/cefepime was evaluated against carbapenem- and colistin-resistant Klebsiella pneumoniae isolates.

Methods: Non duplicate K. pneumoniae (n=185), resistant to colistin as well as non-susceptible to carbapenems were collected (2018-2019) at two large tertiary care hospitals in India.

Effectiveness of Different Etching Agents on Enamel Surface and Shear Bond Strength: An In Vitro Evaluation.

Background Enamel etching is of utmost importance during the orthodontic bonding procedure. Phosphoric acid, hydrofluoric acid, and citric acid are used in specific concentrations to create surface irregularities on enamel surfaces, enhancing the bond strength of the orthodontic attachment. Therefore, it is essential to evaluate the type of etchant for reliable orthodontic bracket bonding with minimal damage to the enamel surface.

Peripheral Nerve Sheath Tumor: A Diagnostic and Therapeutic Challenge.

Introduction: Peripheral nerve tumors are a group of rare soft tissue tumors of neuro-ectodermal origin. Although the majority of them are benign in nature, up to 10% can be malignant. The symptoms depend on the site, size, and structures compressed by the tumor.

Clinical and Genomic Evolution of Carbapenem-Resistant Klebsiella pneumoniae Bloodstream Infections over Two Time Periods at a Tertiary Care Hospital in South India: A Prospective Cohort Study.

Introduction: The objective of this study was to examine the evolution of carbapenem-resistant Klebsiella pneumoniae (CRKp) infections and their impact at a tertiary care hospital in South India.

Methods: A comparative analysis of clinical data from two prospective cohorts of patients with CRKp bacteremia (C1, 2014-2015; C2, 2021-2022) was carried out. Antimicrobial susceptibilities and whole genome sequencing (WGS) data of selected isolates were also analyzed.

Persistent bacteremia predicts poor outcomes among neutropenic patients with carbapenem-resistant gram-negative bloodstream infections receiving appropriate therapy.

Purpose: Identifying persistent bacteremia early in patients with neutropenia may improve outcome. This study evaluated the role of follow-up blood cultures (FUBC) positivity in predicting outcomes among patients with neutropenia and carbapenem-resistant gram-negative bloodstream infections (CRGNBSI).

Methods: This retrospective cohort study conducted between December 2017 and April 2022 included patients more than 15 years old with neutropenia and CRGNBSI, who survived for ≥ 48 h, receiving appropriate antibiotic therapy and had FUBCs.

Hypervirulent infection presenting as endocarditis and liver abscess.

Hypervirulent infection, reported commonly from South-east Asia, is predominantly community-acquired and affects young healthy adults. Although abscesses of liver, brain and muscles, endophthalmitis or osteomyelitis have been reported, Infective endocarditis is a rare manifestation. This report illustrates a patient with uncontrolled diabetes mellitus who presented with clinical features of liver abscess with an incidental finding of infective endocarditis.

Hybrid Plasmids Encoding Antimicrobial Resistance and Virulence Traits Among Hypervirulent ST2096 in India.

Background: Hypervirulent variants of (HvKp) were typically associated with a broadly antimicrobial susceptible clone of sequence type (ST) 23 at the time of its emergence. Concerningly, HvKp is now also emerging within multidrug-resistant (MDR) clones, including ST11, ST15, and ST147. MDR-HvKp either carry both the virulence and resistance plasmids or carry a large hybrid plasmid coding for both virulence and resistance determinants.

Aerobactin Seems To Be a Promising Marker Compared With Unstable RmpA2 for the Identification of Hypervirulent Carbapenem-Resistant : and Evidence.

Background: The incidence of hypervirulent (hv) carbapenem-resistant (CR) (Kp) is increasing globally among various clones and is also responsible for nosocomial infections. The CR-hvKp is formed by the uptake of a virulence plasmid by endemic high-risk clones or by the uptake of plasmids carrying antimicrobial resistance genes by the virulent clones. Here, we describe CR-hvKp from India belonging to high-risk clones that have acquired a virulence plasmid and are phenotypically unidentified due to lack of hypermucoviscosity.

Distinctive Mobile Genetic Elements Observed in the Clonal Expansion of Carbapenem-Resistant in India.

(Kp), a common multidrug-resistant pathogen, causes a wide spectrum of nosocomial infections with high rates of morbidity and mortality. The emergence of pan drug-resistant international high-risk clones such as ST258, ST14, ST15, ST147, and ST101 is a global concern. This study was performed to investigate the carbapenemases, the plasmid profile, and the clonal relationship among Indian .

Ultrasound-based stroke/cardiovascular risk stratification using Framingham Risk Score and ASCVD Risk Score based on "Integrated Vascular Age" instead of "Chronological Age": a multi-ethnic study of Asian Indian, Caucasian, and Japanese cohorts.

Background: Vascular age (VA) has recently emerged for CVD risk assessment and can either be computed using conventional risk factors (CRF) or by using carotid intima-media thickness (cIMT) derived from carotid ultrasound (CUS). This study investigates a novel method of integrating both CRF and cIMT for estimating VA [so-called integrated VA (IVA)]. Further, the study analyzes and compares CVD/stroke risk using the Framingham Risk Score (FRS)-based risk calculator when adapting IVA against VA.

Identification of plasmids by PCR based replicon typing in bacteremic Klebsiella pneumoniae.

Background: Klebsiella pneumoniae is a notorious pathogen with plasmid mediated resistance to all classes of antibiotics. It is important to determine the plasmid profile coding for resistance genes. Plasmid profile varies among geographical regions and tracking the types helps in determining the MDR and XDR K.

Complications and Outcome of Electrical Burns in Manipal, India: 6-Year Institutional Report.

Background: Electrical burns, although less prevalent, are devastating injuries and are associated with high morbidity and mortality. This study assessed the socio-demographic characteristics, complications, surgical interventions and outcomes among electrical burn victims.

Methods: From 2013 to 2018, patients who suffered from electric burns and were admitted to Burns Unit, Department of Plastic Surgery, Kasturba Hospital, Manipal, India were enrolled.

In-vitro activity of tigecycline and comparator agents against common pathogens: Indian experience.

Introduction: Tigecycline Evaluation and Surveillance Trail (TEST) study is an on-going global surveillance. The study was performed to determine the susceptibility of common pathogens to tigecycline and comparator antibiotics by broth microdilution (BMD) at two tertiary care centres in India from 2015 to 2017.

Methodology: Total of 989 isolates collected from various clinical specimens between January 2015 and September 2017 from two centres in India were included.

Bad bug, no test: Tigecycline susceptibility testing challenges and way forward.

Tigecycline is a reserve antibiotic increasingly used for the treatment of multidrug-resistant bacteria, especially Klebsiella pneumoniae and Acinetobacter baumannii. At present, there are concerns regarding the testing and interpretation of tigecycline susceptibility to bugs such as K. pneumoniae and A.

Extremely High Mortality Rates in Patients with Carbapenem-resistant, Hypermucoviscous Klebsiella pneumoniae Blood Stream Infections.

Background: Infections caused by carbapenem resistant K. pneumoniae are increasing and associated with high mortality rates. There are increasing reports of hypermucoviscous/ hypervirulent K.

Rapidly disseminating bla carrying Klebsiella pneumoniae belonging to ST231 in India: multiple and varied mobile genetic elements.

Background: Recently, in India, there has been a shift from NDM to OXA48-like carbapenemases. OXA-181 and OXA-232 are the frequently produced variants of OXA48-like carbapenemases. OXA48-like carbapenemases are also known to be carried on transposons such as Tn1999, Tn1999.

Molecular characterization of colistin-resistant & its clonal relationship among Indian isolates.

Background & Objectives: Klebsiella pneumoniae (KP), a common cause of invasive infections, is often extensively drug resistant in India. At present, studies on resistance mechanism and clonal relationship of KP from India are limited. The present study was undertaken to determine the resistance mechanism and clonal relationship of colistin-resistant isolates obtained from various specimens.

Emergence of ST147 Klebsiella pneumoniae carrying bla on IncA/C2 with ompK35 and ompK36 mutations in India.

India is known to be endemic to NDM carbapenemases. However, NDM-7 among Klebsiella pneumoniae has not been described from India. Apart from carbapenemases, ompK35 and ompK36 also contribute to carbapenem resistance in K.

First Report of Whole-Genome Sequence of Colistin-Resistant subsp. Producing KPC-9 in India.

carbapenemase (KPC) is a class A carbapenemase endemic in the United States, China, South America, and Europe but is rarely reported from India. A single report of KPC-9 from in Israel has been published. has been classified into three phylogenetic groups: group 1 consists of and its subspecies, group 2 consists of and its subspecies, and group 3 consists of .

Detection of chromosomal and plasmid-mediated mechanisms of colistin resistance in Escherichia coli and Klebsiella pneumoniae from Indian food samples.

Objectives: Numerous previous publications on the detection of bacterial isolates harbouring the mcr-1 gene from animals and humans strongly suggest an underlying route of transmission of colistin resistance via the food chain. The aim of this study was to investigate the presence of colistin-resistant (Col-R) bacteria in Indian food samples and to identify the underlying mechanisms conferring colistin resistance.

Methods: Raw food material, including poultry meat, mutton meat, fish, fruit and vegetables, collected from food outlets in Chennai, India, were processed to identify Col-R bacteria using eosin methylene blue agar supplemented with colistin.

KPC-2 producing ST101 Klebsiella pneumoniae from bloodstream infection in India.

This study characterizes KPC-2 producing Klebsiella pneumoniae belonging to ST101. Whole genome sequencing using the Ion Torrent PGM platform with 400 bp chemistry was performed. blaKPC-2 was found on an IncFIIK plasmid associated with ISKpn6 and ISKpn7 without Tn4401.