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Background: Sepsis is one of the major causes of mortality and morbidity in hospitals. Bloodstream infections (BSI) affect approximately 2% of all hospitalized patients and 70% of patients admitted to the Intensive Care Units. Detection of BSI is one of the most important tasks performed in the microbiology laboratory. Aims and Objectives: This study aims to evaluate direct antimicrobial susceptibility tests (DAST) from positive blood culture broth in suspected bacteremia and compare the DAST and conventional antimicrobial susceptibility testing (CAST) of the isolates. Materials and Methods: A descriptive study involving a total of 112 aerobic blood culture bottles flagged positively by the automated Identification System (Bac T/Alert3D) was processed. The bacteria were pelleted by two-step centrifugation of the broth from the bottle and used to make a smear for Gram stain as well as an inoculum for antimicrobial sensitivity testing by Kirby-Bauer disk diffusion method. Results: Out of 842 blood culture samples, 112 flagged positive cultures were subjected to direct gram film, 28 were found to be polymicrobial, 24 Gram-positive cocci, and 60 were Gram-negative bacilli. There was a complete match between the direct Gram stain result from the positive bottle and the Gram stain from subcultures from the bottles obtained after overnight culture on solid media. Conclusion: This study has demonstrated good concordance between the DAST and CAST results. Hence, direct AST can be implemented in a routine diagnostic laboratory. Direct AST will be helpful to decrease the turnaround time and to start early antimicrobial therapy in critically ill patients. [ABSTRACT FROM AUTHOR]

Background: Implant site and periprosthetic joint infections (PPJI) are of major concern with tremendous improvement in orthopedic operative procedures. Early diagnosis of infection is the cornerstone for success rate and prevention of implant failure. The need for inflammatory biomarkers followed by culture sensitivity remains inevitable in the diagnosis of infection. Aims and Objectives: The aim is to study the prevalent biofilm-forming pathogens and to correlate with antimicrobial resistance and also to estimate inflammatory markers to predict the presence of PPJI. Materials and Methods: A descriptive cross-sectional study involving 57 patients showing signs of PPJI was evaluated. Clinical samples of these cases were processed, the bacterial pathogens were isolated and bio-film formation was tested. Inflammatory markers C-reactive protein by latex agglutination and interleukin-6 (IL6) by ELISA is determined. Results: A total of 36 bacterial pathogens are isolated, 17% are Grampositive cocci (GPC) and 46% are Gram-negative bacilli (GNB). Among these, 54% are biofilm producers and pseudomonas species (33%) are predominant. Antibiotic susceptibility studies showed GPC to be highly sensitive to linezolid (100%) and vancomycin (100%). Among GNB, pseudomonal species showed susceptibility of 85%, 57%, and 47% to meropenem, amikacin, and piperacillin–tazobactam, respectively. Acinetobacter is the most resistant isolate. The IL value of 19.5 arrived by the receiver operating curve showed maximum sensitivity and minimal false positivity. Conclusion: Assessing the infection-specific biomarkers like IL6 levels is advantageous in earlier detection of implant site infection and aid in instituting specific antibiotics for the most common implant and PPJI before permanent implant failure and sepsis. [ABSTRACT FROM AUTHOR]

Upper limb shows a large number of arterial variations. This case report describes the presence of additional superficial ulnar artery which was used to raise a pedicle flap to cover an arm defect thus avoided using the main vessel of the forearm - radial or ulnar artery. Vascular anomalies occurring in the arm and forearm tend to increase the likelihood of damaging the superficial anomalous arteries during surgery. Superficial ulnar or radial arteries have been described to originate from the upper third of the brachial artery; here we report the origin of the anomalous superficial ulnar artery originating from the brachial artery at the level of elbow with the concomitant presence of normal deep radial and ulnar arteries.