SHORT COMMUNICATION: Non-Fermenters in Human Infections with Special Reference to Acinetobacter Species in a Tertiary Care Hospital from North Karnataka, India

Background: Non-fermenters are a group of aerobic non-spore forming gram negative bacilli that are either incapable of utilizingcarbohydrates as a source of energy or degrade them via oxidative rather than fermentative pathway. These are increasingly been reported from the cases of nosocomial infections. Aims and Objectives: This study was undertaken aiming to identify, characterize all nonfermenters and further study of Acinetobacterisolates. Materials and Methods: A total 116 non-fermenters isolated from various specimens obtained from the patients in tertiarycare hospital. Gram negative bacilli which failed to produce acid on Triple Sugar Iron Agar (TSI) were identified by employing battery oftests. The Acinetobacter isolates were further speciated and antimicrobial susceptibility testing done by Kirby Bauer disc diffusion technique. Results: Non-fermenters isolated were Pseudomonas aerugionsa (69.8%), Acinetobacter species (18.9%),Stenotrophomonas maltophilia (4.3%), Burkholderia cepacia (3.4%), Alcaligenes fecalis (1.7%) and Pseudomonas fluorescens (1.7%). Most of the isolates showed susceptibility to imipenem (86.3%) whereasnone of the isolates were sensitive to cephalexin and co-trimoxazole. Conclusion: This study highlights that, after Pseudomonas aeruginosa, Acinetobacter species is the most common non-fermenter. Majority of the isolates of Acinetobacter Species were ofnosocomial origin and were multidrug resistant, which underlines the importance of proper vigilance of these infections in hospital setting

CASE REPORT: Primary Cutaneous Nocardiosis of Axillary Region: A Case Report

Background: Nocardiosis is an uncommon but world-wide infection caused by several species of soil-borne aerobic bacteria belonging to the genus Nocardia. Primary cutaneous nocardiosis (PCN) is an uncommon entity. It usually occurs among immunocompetent but occupationally predisposed individuals. Clinically, it can present as acute infection (abscess or cellulitis), mycetoma, or sporotrichoid infection [1]. Here we are reporting a case of PCN presented as mycetoma in axilla which is a rare site. Case History: The patient had extensive lesions in and around the axilla, which could be attributed to the fact that the patient, being an agriculturist, had been exposed to recurrent trauma while carrying firewood and soiled sacks. Single lesion initiated four years ago, progressed to multiple lesions with few healed scars. Despite the treatment in several hospitals, lesions recurred. The present patient was diagnosed as PCN caused by Nocardia brasiliensis and appropriately treated. Conclusion: Nocardia infection should be considered in the differential diagnosis of a supportive and granulomatous dermatitis that presents clinically as multiple discharging sinuses with papules and nodules in and around axilla apart from tuberculosis

Semi-quantitative analysis of SARS-COV-2 IgG antibodies following ChAdOx1-nCOV (CovishieldTM) Vaccination

Purpose:  Severe Acute Respiratory Syndrome Coronavirus 2 (SARS COV-2) pandemic has devasted the world in the 21st century. It is still unclear whether people vaccinated will develop protective and long lasting immunity. There is a gap in the knowledge about quantity and duration of persistence of antibodies following vaccination especially in health care workers. Hence aimed to evaluate the B cell immune response following Covishield vaccine and also followed up for persistence of antibodies for 6 months in Indian health professionals Materials and Methods: This is a prospective cohort study which was conducted at tertiary care hospital, south India. The blood samples were collected after 2nd dose of vaccine at 28 days, 60 days, 120 days. Our Primary objectives were to semi-quantitatively analyse SARS-COV-2 IgG antibodies following Covishield vaccination in health care workers and to follow-up the vaccinated individuals for getting infected with SARS COV2 and persistence of antibodies for 6 months Results: Out of 30 Health care workers, 28(93.3%) were seropositive and 2 (6.7%) were seronegative. Out of 2 seronegative, one participant acquired SARSCOV-2 infection with severe symptoms. There was approximately 50% reduction in antibody levels in almost all seropositive individuals after 3 months of 2nd dose. Even after 6 months 25 (83.3%) were seropositive, 2(6.7%) were seronegative and 3(10%) were borderline. When the IgG antibody ratio levels of 28 days following 2nd dose of vaccination was compared with levels after 6 months showed P value of 0.024 which is <0.05 implies statistically significant Conclusion: Covishield vaccine induced good immune response in majority of the participants, the levels were sustainably positive till 6 months but decreasing pattern. The vaccine induced antibodies prevented the severe symptoms among vaccine breakthrough infection