Background: Multidrug resistant Acinetobacter infection has emerged as an important pathogen in neonatal sepsis in the recent years causing morbidity as well as mortality. Materials and Methods: A retrospective analysis was performed over a one and a half year period of all neonates admitted with sepsis in our neonatal intensive care unit (NICU), who developed Acinetobacter infection and to identify mortality-associated risk factors in these neonates. Results: Incidence of neonatal septicaemia due to Acinetobacter species was 9.18%. All were cases of early onset sepsis. Predominant species isolated was Acinetobacter baumanii (67.5%). The major symptoms were lethargy and poor feeding. The major signs were tachypnoea, rib retraction, and respiratory distress. The major fetal risk factors were low birth weight and prematurity. Overall, 53.75% were multidrug resistant (MDR) Acinetobacter. Resistance to more than two drugs (MDR) was statistically significant in A. baumanii as compared with nonbaumanii. Overall mortality due to Acinetobacter neonatal sepsis was 20%. Septicemia due to A. baumanii was associated with higher mortality than those due to nonbaumanii isolates. Lethargy, tachypnoea, rib retraction, tachycardia, respiratory distress, and mechanical ventilation were significant predictors of mortality. Conclusion: Multidrug resistant Acinetobacter infection is fatal, particularly in premature and low birth weight neonates. Therefore, an effective infection control policy and rational antibiotic use are mandatory in neonatal intensive care areas of each hospital in order to control Acinetobacter infection and improve outcome.

Background: Acute respiratory infections (ARI) are leading global cause of under-five mortality and morbidity. Objective: To elicit the prevalence and risk factors associated with ARI among under-five children. Materials and Methods: A community-based cross-sectional study was undertaken in 21 registered urban slums of Guwahati in Assam to determine the prevalence and risk factors associated with ARI among 370 under-five children from 184 households and 370 families. Results: The prevalence of ARI was found to be 26.22%; infants and female children were more affected. Majority of the ARI cases were from nuclear families (84.54%), living in kutcha houses (90.72%) with inadequate ventilation (84.54%), overcrowded living condition (81.44%), with kitchen attached to the living room (65.98%) and using biomass fuel for cooking (89.69%). ARI was significantly associated with ventilation, location of kitchen in household; presence of overcrowding, nutritional status, and primary immunization status also had impacts on ARI. Conclusion: The present study had identified a high prevalence of the disease among under-fives. It also pointed out various socio-demographic, nutritional, and environmental modifiable risk factors which can be tackled by effective education of the community.

Objectives: Testing of blood-fed mosquitoes plays an integral role in arbovirus surveillance and in understanding its interaction mechanisms between host, vector and reservoir. The present study was undertaken to evaluate the efficacy of two different traps (gravid and resting boxes) for collection of blood-fed mosquitoes in the northwestern part of Riverside County. Materials and Methods: Three trapping sites were selected in the Northwest Mosquito and Vector Control District of Riverside County, California. At each site resting boxes and gravid traps were set; and mosquitoes were collected on a weekly basis between July-December 2009. Mosquitoes were transported over blue ice, identified up to species level on chill table, and classified as male, female and blood-fed females. Results: During this study period, 3953 mosquitoes (826 blood-fed females) belonging to three different genera and eight species were collected; resting boxes collecting maximum number (seven) of mosquito species. Overall as well as individually in each trap kind, the most abundant mosquito species collected was Cx. quinquefasciatus. The proportion of blood-fed females of the Culex species collected in resting boxes was 28.8 times more, while of blood-fed females of Cx. quinquefasciatus was 32.2 times more than the proportion collected from gravid traps. Conclusions: Overall, the proportion of blood-fed female mosquitoes collected for each species trapped was highest in resting boxes. Additionally, resting boxes showed the advantage of extremely low running and maintenance cost; generation of no hazardous waste; quick turnaround time in terms of mosquito collection per man-hour spent; and they were less prone to vandalism or thefts.

Background: Since the early nineties, a new methicillin-resistant Staphylococcus aureus (MRSA) has existed in a form correlating with community health personnel. Community-acquired MRSA (CA-MRSA) could be differentiated from healthcare-associated MRSA (HA-MRSA) microbiologically, epidemiologically, and molecularly. Aims: To determine the prevalence, risk factors of MRSA infections in community and hospital. Settings: The incidence and risk factors for CA-MRSA and HA-MRSA among patients of medical, surgical, and pediatrics wards and ICU at a Kuwaiti teaching hospital between 1 March 2011 and 30 November 2011 were studied. Materials and Methods: Cultures for MRSA were taken from nasal (nostril), groin, axilla, wound, sputum, or throat, and the inguinal area in all enrolled patients upon admission. All preserved isolates were examined for their susceptibility to different types of antibiotics. Results and Conclusion: A total of 71 MRSA patients admitted to different hospital wards were examined. Among these patients, 52 (73.2%) were carriers of MRSA before they were admitted to the hospital. Nineteen patients (26.8%) were found to have acquired MRSA during their stay in the hospital. Twenty-nine patients (40.8%) were given mupirocin local skin antibiotic. Binomial and the t-test (paired) were used to compare the prevalence of CA-MRSA and HA-MRSA; significant correlation (P < 0.05) between the type of MRSA and different wards, sites, and lengths of hospital stay was found. The level of serum albumin that is routinely measured at hospital admission is a predictor to MRSA infection. This study suggests that S. aureus and MRSA should become a national priority for disease control to avoid outbreaks.

A five-year-old boy with acute on chronic ear discharge and fever was diagnosed to have tubercular otitis media (TOM) with Staphylococcus aureus co-infection. His chest X-ray was suggestive of miliary tuberculosis. The clinical presentation of the child with a brief review of the literature pertaining to the case is being discussed in this report.

A 43-year-old male living in Bengaluru sought emergency services due to high-grade fever, headache, myalgia, abdominal pain and distension. Platelet count (except the first-96,000/mm ³ ) and coagulation profile was in normal limits. The dengue serology was positive for IgM and Ig G (immunoglobulin M and G) antibodies. Ultrasound abdomen showed gross ascites, mild bilateral pleural effusion and hepatosplenomegaly. The patient continued to have abdominal pain and progressive distention Ascitic tap was hemorrhagic. Later laparoscopy showed 1.5 liters peritoneal fluid with blood clots and mild diffuse congestion of the peritoneum. Liver, spleen and blood vessels were normal. Then what would be the possible mechanism to explain hemoperitoneum, is it the increased vascular permeability caused by the virus? India being endemic for dengue illness, it is an interesting and rare case presentation.

A rare case of an abdominal aortic aneurysm (AAA) infected by Listeria monocytogenes in a 72-year-old male diabetic farmer, is reported. Our patient had a history of a recent pneumonia that could have been caused by Listeria too. Aneurysm infection was manifested by fever and abdominal and back pain, which prompted investigation with CT scanning that revealed a 4.9 cm AAA with typical signs of infection. He underwent urgent AAA repair with aortobifemoral bypass grafting and had an uneventful course. Aneurysm content microbiology revealed Listeria monocytogenes and following a 9-week course of antibiotics our patient remains asymptomatic 11 months later.