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Introduction: Tuberculosis, the most common infectious disease with prevalence of 9.6 million globally. Most prevalent (23%) in India. Extrapulmonary tuberculosis (EPTB) accounts for 20% of total burden of tuberculosis. Rapid detection of Mycobacterium Tuberculosis (MTB) is essential for effective disease management. CBNAAT (Cartridge Based NucleicAcid Amplification Test) or GeneXpert MTB/RIF assay - novel diagnostic tool to detect MTB and RIF resistance simultaneously. WHO recommends its utility for non-respiratory samples also. Burden of EPTB and drug resistance vary from place to place. Objective: Study was conducted to gather information about burden of disease in our locality and to assesutility of CBNAAT in detecting MTB and rifampicin resistance in suspected EPTB cases. Methods: Retrospective analysis of 281 samples from suspected cases collected in falcon tubes and processed using CBNAAT. Result: Total of 281 extrapulmonary samples received, 67(23.8%) were positive and 214(76.1%) were negative for MTB. Of 67 positives, RIF resistance detected in 1(1.49%) case. Maximum number of MTB detected in the age group 21-30 years (n=23, 34.3%). Among 165 males and 116 females, MTB detected in 44(26.6%) and 23(19.8%) respectively. Out of 281 patients, 24(8.54%) were HIV positive. Of these 24, only 8(33.3%) found positive for MTB. Among 257 non-HIV patients, MTB detected in 59(22.9%). Among different samples received, maximum number were Pleural fluid n=115(40.9%) and Maximum MTB positives found in FNAC (of lymphnodes) samples [n=35(52.2%)]. : CBNAAT is a rapid test to detect MTB and rifampicin resistance simultaneously in EPTB and it reduced the treatment abuse in suspected cases.

Introduction: Foot ulcers are one of the common complications of diabetes mellitus. Diabetic foot ulcer infections are usually polymicrobial infections. For effective treatment, quick isolation and identification of causative organisms with appropriate antibiotic susceptibility testing is needed. Objective: Isolation and identification of bacteria using routine media and HiCrome UTI agar. Materials and Methods: Samples were taken from all Type II diabetes mellitus patients with foot ulcers attending hospital. Samples were collected from deeper portion of the ulcer using 2 sterile swabs and processed using conventional methods and HiCrome UTI agar. Antibiotic susceptibility testing was done on Mueller Hinton agar according to CLSI guidelines. Results: Among 100 samples tested, 138 organisms were isolated as 38% of samples yielded mixed growth. Conventional methods failed to detect 6 (4.3%) isolates form mixed cultures. HiCrome UTI agar isolated all organisms in the cultures including 4 isolates of enterococci and 2 isolates of MSSA, which were missed in conventional methods (p < 0.01). Pseudomonas (22.4%) was commonest organism isolated. Followed by Klebsiella spp. (18.8%), Proteus spp. (15.2%), MSSA (13%), Escherichia coli (11.5%), Citrobacter spp. (7.2%), MRSA (7.2%), Enterococcus spp. (4.3%). Conclusion: Gram negative organisms (75.3%) were predominantly isolated in the study. HiCrome UTI agar can be used for primary identification and quick isolation of organisms where facilities for routine culturing are not available. It is both sensitive and specific in isolating and identifying organisms as in polymicrobial infections.

Introduction: To study the prevalence of asymptomatic bacteriuria (ASB) in diabetics compared to non-diabetics and to determine the associated host factors responsible for ASB in diabetics. Materials and Methods: 250 diabetics and 100 controls were enrolled in the study and were screened for ASB using semi-quantitative culture methods and UTIchrom agar. The samples were screened for glucosuria, ketonuria and pyuria. Results: ASB was more common in diabetics compared to non-diabetics(12.8% v/s 6% ) and the increase was more in female diabetics when compared to female non-diabetics(16% v/s 6.15%) whereas male counterparts did not show much difference from the non-diabetics (6.09% v/s 5.71%). There was significant influence of age, duration of diabetes, glucosuria, ketonuria, proteinuria and pyuria on the incidence of ASB in diabetics thus proving them as possible risk factors for development of ASB. E.coli was the most common organism found in both diabetic as well as non diabetic cases of ASB (40.6% and 57.14% respectively). The next frequent organisms were Klebsiella and Staphylococcus. The sensitivity pattern was similar in both the population with ASB. Culture on UTI CHROMagar yielded quicker results when compared to standard culture methods. Conclusion: ASB is almost 3 times more common in female diabetics compared to female non-diabetics whereas there is not much difference among the male counterparts. The risk factors for ASB in diabetics included age, longer duration of diabetes, poor glycaemic control and renal dysfunction indicated by proteinuria. Culture on UTI CHROMagar is an easy and faster means of identification of organisms.