Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 6th Annual Bacteriology and Parasitology Meeting Singapore.

Day 1 :

Conference Series Bacteriology Asia Pacific 2017 International Conference Keynote Speaker Mok Yu-Keung photo
Biography:

Mok Yu-Keungn has his expertise in determining the structural/functional relationship of protein involved in human diseases using both Nuclear Magnetic Resonance (NMR) and X-ray crystallography.

Abstract:

Type III secretion systems (T3SSs) are adopted by pathogenic bacteria for the transport of effector proteins into host cells through the translocon pore comprised of major and minor translocator proteins. Both translocators require a dedicated chaperone for solubility. Despite tremendous efforts in the past, structural information regarding the chaperone:translocator complex and the topology of the translocon pore have remained elusive. Here, we report the crystal structure of the major translocator, AopB from Aeromonas hydrophila AH-1 in complex with its chaperone, AcrH. Overall, the structure revealed unique interactions between the various interfaces of AopB and AcrH with the N-terminal molecular anchor of AopB crossing into the N-terminal arm of AcrH. AopB adopts a novel fold and its transmembrane regions form two pairs of helical hairpins. From these structural studies and associated cellular assays, we deduced the topology of the assembled T3SS translocon with both termini remain extracellular after membrane insertion

Keynote Forum

Baveja CP

Director Professor and Head of Microbiology

Keynote: Cartridge based nucleic acid amplification test (CBNAAT): A new tool in diagnosis of osteoarticular tuberculosis

Time : 10:45-11:30

Biography:

Baveja C P is the Director Professor and Head of Microbiology at Maulana Azad Medical College in New Delhi. He was awarded an International Fellowship at Royal Postgraduate Medical School and Hammersmith Hospital in UK. He has also conducted research work on Polymerase Chain Reaction at London School of Hygiene and Tropical Medicine. He has been teaching Microbiology to medical undergraduates for past three decades. He was honored with the Best Medical Educationist award in 2000. He has been mentoring postgraduates for the last 25 years. He has been involved in research work with particular emphasis on diagnosis of tuberculosis. He has supervised a number of PhD students with research work on tuberculosis. He is also the Nodal Officer and In-Charge for State Reference Laboratory for HIV testing.

Abstract:

Statement of the Problem: Osteoarticular tuberculosis is an important cause of mortality and morbidity in developing countries because of high prevalence. Microbiological diagnosis of osteoarticular tuberculosis is difficult since it is mostly a paucibacillary disease and the culture method takes long time for its diagnosis. The purpose of this study was to evaluate the results of CBNAAT over conventional methods for diagnosis of osteoarticular tuberculosis.

 

Methodology & Theoretical Orientation: Clinically suspected cases of osteoarticular tuberculosis having an abscess were enrolled in the study. A total of 45 samples were studied. Five milliliter of aspirate/Pus was obtained from each case and processed as follows: (1) Direct microscopy by Ziehl-Neelsen (ZN) Staining, (2) Culture on Lowenstein-Jensen (LJ) medium, (3) Culture in Mycobacteria Growth Indicator Tube (MGIT) and (4) CBNAAT analysis.

 

Findings: Out of the 45 samples tested, 19 (42.22%) were positive for Mycobacterium tuberculosis (MTB) by CBNAAT, 11 (24.44%) showed growth of Mycobacterium tuberculosis in MGIT, 9 (20.00%) showed growth of Mycobacterium tuberculosis on Lowenstein-Jensen medium and only 4 (8.89%) showed presence of Acid Fast bacilli on Ziehl-Neelsen staining. Of the 19 samples that were positive for MTB using CBNAAT, 3 (15.79%) samples were also detected as Rifampicin resistant.

 

Conclusion & Significance: The foremost benefit of CBNAAT for diagnosis of osteoarticular tuberculosis was that it was able to detect additional 10 cases as compared to LJ culture. The test results were available within 1 day, greatly decreasing the turnaround time. Through this study CBNAAT was found to have great potential for diagnosis of osteoarticular tuberculosis earlier than the conventional methods.

  • Infectious Diseases | Parasitology | Bacterial Diseases | Bacterial Clinical studies | Bacterial Pathogenesis
Location: Seletar Foyer

Session Introduction

Ian A Myles

National Institutes of Health in Bethesda USA.

Title: Transplantation of human skin microbiota in models of atopic dermatitis

Time : 11:50-12:20

Speaker
Biography:

Ian A Myles works for the National Institutes of Health in Bethesda in USA. His research focus is on the therapeutic use of live bacteria to treat atopic dermatitis. He has also published on the use of cell lysate therapy and various aspects of immuno-nutrition. He is also an Officer with the US Public Health Service Commissioned Corps, assisting in the vaccination trials for Ebola and more recently Zika virus. Overall his work examines how early environmental and nutritional exposures impact the development of immunity.

Abstract:

Atopic dermatitis (AD) is characterized by reduced barrier function, reduced innate immune activation and susceptibility to Staphylococcus aureus. Host susceptibility factors are suggested by monogenic disorders associated with AD-like phenotypes and can be medically modulated. S. aureus contributes to AD pathogenesis and can be mitigated by antibiotics. Recent work has revealed that the skin microbiome differs significantly between healthy controls and patients with AD, including decreased Gram-negative bacteria in AD. However, little is known about the potential therapeutic benefit of microbiome modulation. To evaluate if parameters of AD pathogenesis are altered after exposure to different culturable Gram-negative (CGN) bacteria collected from human skin. CGN bacteria were collected from healthy controls and patients with AD. Impacts on cellular and culture-based models of immune, epithelial and bacterial function were evaluated. Representative strains were evaluated in the MC903 mouse model of AD. We found that CGN bacteria taken from healthy volunteers but not from patients with AD were associated with enhanced barrier function, innate immunity activation and control of S. aureus. Treatment with CGN from healthy controls improved outcomes in a mouse model of AD. These findings have led to the formation of a clinical trial using a live-biotherapeutic approach for treatment of patients with AD.

Biography:

Dilip Kumar, Singapore Immunology Network, Singapore
 

 

Abstract:

Resistin is a member of adepokine family of cytokines and is known to modulate a diverse set of chemokines and cytokines. In humans, resistin is primarily produced by immune cell other than adipocytes which is the major source in mouse. It has been widely studied in the context of human inflammatory and metabolic diseases. The putative role of resistin in the pathogenesis of human diseases led to several genetic studies in different populations. Resistin is well known to be regulated by Cis- regulatory variants and also led to the predisposition towards diseases, but recognizing the precise targets, mechanisms and biological implications of resistin associated cis-regulatory variants are still poorly understood.

Based on whole blood, cell type specific eQTLs, resistin promoter reporter analysis, EMSA, inhibition study and bisulphite sequencing, we propose that the suppression of resistin promoter is the underlying mechanisms for genetic regulation of resistin expression in monocytes. Also a genetically defined Cohort based immune-phenotyping and plasma biomarkers analysis showed a significant modulation of immune cells and plasma biomarker which are known to be associated with inflammatory diseases.

Our study could provide detailed understanding about the role of resistin associated genetic cis-regulatory variants in the context inflammatory diseases and leads to the better identification and design of new therapeutic targets in the field of inflammation. 

Speaker
Biography:

Eun-Hee Shin has her expertise in immunology and diagnosis in parasitology and tropical medicine. In particular, she studied on biological and immunological response of a protozoa, Toxoplasma gondii in the infected host and published many papers in this area. Besides, she has worked in the field of the mucosal immunity in other water-borne protozoa and food borne trematode. Moreover, she studied on the immune response of natural products as an immunologist. 

Abstract:

Profilin-like protein in Toxoplasma gondii (TgPLP) is a Toll-Like Receptor (TLR) agonist. In this study, we investigated whether TgPLP has an adjuvant effect on immune function in autologous whole-tumor-cell vaccine (AWV) treatment. Mice vaccinated with AWV together with recombinant TgPLP protein had smaller CT26 tumors and increased survival. TgPLP treatment strongly increased the production of IL-12 through MyD88 signaling and several chemokines, including CCL5, CCL12 and XCL1, in bone marrow-derived macrophages (BMMs). In addition, TgPLP increased the phagocytosis of tumor cells by BMMs and promoted immune cell mobility on a tumor-matrigel scaffold. TgPLP triggered immune responses as demonstrated by increased expression of antigen presenting cell markers (MHC class I and II, B7.1 and B7.2) in BMMs and increased IL-12 and IFN-γ expression in mice. Mice vaccinated with AWV and TgPLP had more immune cells (CD4+ and CD8+ T cells, natural killer cells and macrophages) in the spleen and higher total IgG and IgG2a concentrations in the blood than mice vaccinated with AWV alone. These findings suggest that TgPLP is a TLR-based vaccine adjuvant that enhances antitumor immune responses during vaccination with AWV.

Speaker
Biography:

Samuel Mailafia is an expert in microbiology and molecular epidemiology. His passion in eradicating emerging viral zoonoses in Nigeria and Africa is overwhelming. His open and contextual trace-back analysis of true sources of infection of bacterial and viral diseases has stimulated a lot of interest in global control of infectious diseases.

Abstract:

Statement of the Problem: Nigeria and many parts of the world have experienced outbreaks of emerging viral zoonoses. These diseases resulted in serious economic losses such as condemnation of infected animals and carcasses, eventual death and debilitation. Public health concern in humans results in global panic and death. Africa presents conducive environment for the sustenance of the reservoir hosts and vectors of this diseases. The poor state of health facilities in developing countries poses serious threats to the diagnosis, control, prevention and total eradication of the disease. Emerging viral zoonoses recently reported within the past two years in Nigeria includes: Avian influenza, Ebola disease and Lassa fever and Zika viral disease. The factors that led to the emergence of these zoonoses included environment, demography, pathogen mutation and presence of host or vectors. Scientists have reported that environmental changes and mutation could disseminate progeny virions which could increase risk of infection. However, most of these perspectives have not been verified. The purpose of our study is to seek to address the experience Nigeria had from the control of these diseases with possibility of analyzing the serological and molecular diagnostic tools used to control the disease locally. It is further believed that the information gained will be useful in the device of new strategies for eradication of the disease globally.

 

Findings: Emerging viral zoonoses have created great fear in Nigeria. Unconventional traditional remedies were sought, the government through global assistance initiated and executed local diagnostic framework for the control of these diseases.

 

Conclusion & Significance: The study is significant as it uncovers the risks and diagnostic potentials of Nigeria in controlling emerging diseases.

 

Recommendations: Developing countries needs diagnostic aids. The experience gained in the control of viral zoonoses will be useful in developing new global control programs.

Buddhika Gayani

MPhil, Physical Chemistry, University of Sri Jayewardenepura, Sri Lanka.

Title: Anti-biofilm activity of citrate intercalated layered double hydroxide against selected biofilm forming uropathogens

Time : 14:50-15:20

Speaker
Biography:

Buddhika Gayani is currently an MPhil student of Physical Chemistry at University of Sri Jayewardenepura, Sri Lanka. Her current research work explores nanomaterial solutions for potential anti-biofilm applications. In addition, she works on 3D printing of silicon based polymer materials. She holds BSc special degree in Chemistry from University of Sri Jayewardenepura, Sri Lanka. During her undergraduate research works, she has successfully used bamboo activated carbon for water purification applications.

Abstract:

Background & Aim: Citrate is one of promising anti-biofilm forming agents use to prevent biofilm formation as a catheter lock solution and as an oral intake. However, maintaining concentration of citrate for a long period of time will be beneficial in order to design a prolonged treatment. This study focused to determine the inhibitory effect of citrate intercalated Mg and Al layered double hydroxides (citrate-LDH) as a slow releasing agent against Pseudomonas aeruginosa, Staphylococcus aureus, and Enterococcus faecalis.

 

Methodology: The influence of citrate-LDH synthesized by one step co-precipitation reaction was investigated against mono- and co-cultures of P. aeruginosa, S. aureus and E. faecalis grown in brain heart infusion broth. The inhibitory effect and the minimum inhibitory concentration (MIC) were determined using agar well diffusion method and pour plate method, respectively. The minimum biofilm inhibitory concentration (MBIC) and the minimum killing time for 48 hours matured biofilms were determined by MTT viability assay.

 

Results & Discussion: For all tested strains, the MIC value of citrate-LDH was 1×10-5 g/mL while the MBIC value was 0.01 g/mL for an average 70% reduction and 0.10 g/mL for an average 98% reduction. The minimum killing time was 6 hours for MBIC70 and it was constant for all 48 hours confirming the slow releasing ability of citrate from LDH nanohybrid. The scanning electron microscopic images reveal the biofilm inhibitory effect of citrate-LDH as it has reduced the population of microorganism and extracellular polysaccharide matrix considerably compared to the control.

 

Conclusion: Thus, citrate-LDH has a sustainable biofilm reducible activity against tested uropathogens which will be a potential future anti-biofilm agent in treating urinary tract infections. 

Speaker
Biography:

Balarabe Rabiu Mohammed has completed his PhD in Molecular Entomology from Abertay University, Dundee in collaboration with the Liverpool School of Tropical Medicine (LSTM) in United Kingdom. His areas of specialization have been molecular characterization of genes involved in insecticide resistant insects with particular emphasis on cytochrome p450s and nuclear factor erythroid-2factor (Nrf2) and Aryl Hydrocarbon Receptor (AhR) orthologs. Currently he is involved in the study on the differential expression of AGAP010259 (AhR) and Nf2e1 (Nrf2) candidate genes in some selected strains of Anopheles gambiae (Diptera: Culicidae). His expertise in other research areas covers the management and control of protozoan and helminthic diseases of animals and zoonotic significance.

Abstract:

Statement of the Problem: Gastrointestinal parasites constitute a major impediment to efficient poultry production including turkeys, thereby leading to substantial economic losses. Little is known about these parasites of turkeys in the Federal Capital Territory, Abuja. This research is therefore aimed at determining the prevalence of gastrointestinal parasites of turkey in the Gwagwalada Area Council, Abuja.

 

Methodology: Between April and August 2016, one hundred (100) gastrointestinal tracts (GIT) and fecal samples comprising 33% domestic and 67% exotic breeds of turkeys slaughtered in Gwagwalada Area Council abattoir and slaughter slabs were randomly collected and analyzed for intestinal parasites.

 

Findings: This study revealed that nematode had the highest prevalent rate of infection in both local and exotic breeds. It was further revealed that 10% of the samples were found to be negative for parasites whilst 90% were found to be positive. The only Cestode observed was Raillietina spp. (13%), nematodes (40%) and protozoa (61%). A record of mixed infection was observed in both local and exotic breeds but was higher in exotic breeds with the percentage of single infection 12%, double infection 18%, triple infection 8%, quadruple infection 10% and pentaple infection 42%.

 

Conclusion & Significance: The present findings led to a significant conclusion that Gwagwalada metropolis is highly enzootic for the intestinal parasites of turkeys. This study has implication on the provision of sustainable animal protein for human consumption.

  • Infectious Diseases | Parasitology | Bacterial Diseases | Bacterial Clinical studies | Bacterial Pathogenesis
Location: Atrium Restaurant

Session Introduction

Toshio Hattori

KIBI International University, Japan

Title: Roles of matricellular proteins in host response dynamics in Mycobacterium tuberculosis infection

Time : 09:30-10:00

Speaker
Biography:

Toshio Hattori has his expertise in understanding the immune-pathology of various infectious diseases through matricellular proteins. He has analyzed various infectious disease using two representative MCPs such as Gal-9 and OPN.

Abstract:

Statement of the Problem: Elevated matricellular proteins (MCPs) including osteopontin (OPN) and galectin-9 (Gal-9) were observed in the plasma of patients with Manila-type tuberculosis (TB) in previous study. MCPs interact with variety receptors, proteases and pathogens and can modulate innate and adaptive immune system that affects the pathology of infectious diseases. The purpose of this study is quantification of plasma OPN, Gal-9 and soluble CD44 (sCD44) by ELISAs and other 29 cytokines by Luminex assay. We also studied a TB patient pleural effusion to understand their role in local immune responses.

 

Materials & Methods: 36 patients with pulmonary TB, six subjects with latent tuberculosis (LTBI) and 19 healthy controls (HCs) from Japan. Pleural effusion from a patient was also analyzed. EDTA plasma was used for their analysis. Mononuclear cells from heparinized blood were used for ELISPOT assay.

 

Findings: The levels of OPN, Gal-9 and sCD44 were higher in TB (positivity 61.1%, 66.7% and 63.9%, respectively) than in the HCs. Negative correlations between OPN and ESAT-6-ELISPOT response, between chest X-ray severity score of cavitary TB and ESAT-6-ELISPOT response were observed. Compared to plasma, pleural fluid had increased levels of IFN-g (1.6 vs. 55.5 pg/mL), IL-10, IL-12p40, vascular endothelial growth factor (VEGF) and Gal-9 (3.0 vs. 936.0 pg/mL), respectively.

 

Conclusion & Significance: It was speculated that increased migration of lymphocytes toward the TB lesion in response to OPN signaling. A very high Gal-9 levels was found in pleural effusion and their permeability effect was proposed. These findings suggest that MCPs play fundamental roles in host response dynamics during TB infection.

Kanupriya Kusumakar

Maulana Azad Medical College-Lok Nayak Hospital, India

Title: Bacteriological profile of patients attending infertility clinic

Time : 10:00-10:30

Biography:

Kanupriya Kusumakar is currently pursuing her MD in Microbiology from Maulana Azad Medical College, a premier institute under the University of Delhi in India. She has completed her MBBS from Bangalore Medical College and Research Institute in Bengaluru, India with a Gold Medal in Community Medicine. She is actively involved in various academic and research work at her institute and in teaching medical undergraduates.

Abstract:

Statement of the Problem: Urogenital infection can play an important role in the etiology of infertility. Such infections may often go unnoticed but could hamper infertility. These infections may affect fertility in several ways: By damaging sperm, hampering their motility, altering the chemical composition of the seminal fluid or by producing an inflammatory structure in the tract. The purpose of this study was to identify the bacterial isolates by conventional methods in patients attending infertility clinic.

 

Methodology & Theoretical Orientation: A total of 250 semen samples and 150 cervical samples were examined. The samples were inoculated on blood agar plates containing 5% sheep blood agar and MacConkey’s agar plates. The plates were incubated at 37 oC with 5% CO2 for 24 hours and examined. Biochemical tests were used for identification and confirmation of the bacterial isolates.

 

Findings: In our study, bacterial isolates were seen in 112 (44.8%) of the 250 semen samples and 77 (51.33%) of 150 cervical samples examined. The major organisms isolated from semen samples were Pseudomonas sp. 41/250 (16.4%), Escherichia coli 29/250 (11.6%) and Staphylococcus sp. 24/250 (9.6%). The main organisms isolated from cervical samples were Escherichia coli 12/150 (8.00%), Klebsiella sp. 9/150 (6.00%) and Acinetobacter sp. 3/150 (2.00%).

 

Conclusion & Significance: It is necessary to determine not just the presence of bacteria but also their nature as well as numbers while evaluating an infertile patient. It would be worthwhile to screen routinely all patients for a possible silent urogenital tract infection attending infertility clinic and vigorously institute appropriate antibacterial therapy wherever indicated by significant culture.

Biography:

Abnet Abebe has his expertise Evaluation of malaria. He belong to Ethiopian Public Health Institute, Ethiopia. His research work includes Microscopic diagnosis and evaluation of malaria 

Abstract:

Background: Microscopic diagnosis of Giemsa stained thick and thin blood films by skilled microscopists has remained the standard laboratory method for the diagnosis of malaria. The performance of malaria microscopists in all health facilities have been raised concerns by many experts. Microscopists who are working at malaria rechecking laboratories have to be competent to cross check blood film slides which are collected from testing sites.

 

Objective: The current study aims to assess the performance of malaria microscopists who is working at malaria EQA rechecking laboratories in Ethiopia from February to May, 2015.

 

Methods: A cross-sectional study design was conducted to assess the performance of 107 malaria microscopists who are working at 23 malaria rechecking laboratories in Ethiopia. A set of 12 blood film slides containing known negative and positive (different species, stage, and parasite density) results were distributed to each malaria microscopists. Data was collected and entered into Microsoft Excel sheets and exported to software SPSS version 20 for analysis. Chi-square (for categorical data), sensitivity, specificity, percent agreement and kappa score were calculated to assess laboratory professionals’ performance in detecting and identification of Plasmodium species using light microscopy. Association was taken as significant at P<0.05.

 

Result: A total of 107 study participants were involved in this study, the mean age of the participants was 30±5.04 years and most of them 54 (50.5%) were working at regional reference laboratories. Overall, the sensitivity of participants in detection and species identification of malaria parasites were 96.8% and 56.7%, respectively. The overall agreement on detection and identification of malaria species was 96.8% (Kappa=0.9) and 64.77% (kappa=0.33), respectively. About 34 (31.8%) participants were used unrecommended quantification (+) system. The least malaria species which were identified correctly by the participants were P. malaria (2.8%) followed by and P. ovale (32.7%). Participants at hospital laboratory had the highest percent agreement (72.3%, Kappa=0.51) on species identification. Malaria microscopists working at sub regional laboratory had a better quantification performance (P=0.003). Study participants who were participated on malaria microscopy and quality assurance training had a better performance on parasite quantification (P<0.001).

 

Conclusion & Recommendation: Agreement of the participants with expert microscopists in the identification of different malaria species and quantification were very low. Most participants did not identify P. malaria and P. ovale correctly. Therefore, policy backed regular competency assessment and training for malaria microscopists is essential and mandatory that can assure proper diagnosis and management of malaria in Ethiopia.

Speaker
Biography:

Omoniwa B. Percy is a PhD student of Biochemistry at the University of Ilorin, Nigeria and an early career academic at the Department of Science Laboratory Technology, University of Jos, Nigeria. He has experience in quality control of pharmaceutics and is building a career in lecturing where he contributes his quota through teaching, research and administration. He is presently focusing on ethnopharmacology, reproductive biochemistry, parasitology and biochemical toxicology and has published in local and international journals.

Abstract:

Statement of the Problem: Malaria is a major public health challenge in developing countries. 109 countries were reported endemic to malaria in 2008 leaving 3.2 billion people, nearly half the world’s population at risk of malaria. Plasmodium falciparum reduced sensitivity to ACTs has been reported in Asia and Africa. There is no suitable replacement for ACTs if parasite develops resistance. This highlights the urgent for new antimalarial drugs. This study evaluated the in-vitro antiplasmodial activities of cold and hot aqueous extracts of Ochna schweinfurthiana leaf on P. falciparum. Methodology & Theoretical Orientation: P. falciparum was grown in a 96 well microtitre plate in the presence of RPMI 1640 culture media supplemented with Albumax II. The wells were divided into groups I-XIII: Group I (negative control), groups II, III, IV, V (positive control groups containing 10, 20, 40 and 80 µg/ml of Artemether/Lumefantrine respectively), groups VI, VII, VIII, IX and  X, XI, XII, XIII (treatment groups containing cold and hot aqueous extracts at the respective doses). The microtitre plate was incubated at 37oC in an anaerobic jar and parasitemia taken after 24, 48 and 72 hours. Findings: There was a significant reduction (P< 0.05) in parasitemia of extract-treated groups when compared to the negative control. The 10, 20, 40 and 80 µg/ml doses of the extracts gave a percentage parasite inhibition of 79.77, 81.86, 83.38 and 86.42% (cold extract) and 76.26, 78.54, 82.72 and 85.06% (hot extract) respectively which are significantly lower than 99.71, 99.81, 100.00 and 100.00%  observed in the standard drug after 72 hours. However, Plasmodium lactate dehydrogenase (pLDH) activity in the extract-treated groups did not show any significant difference when compared with the Artemether/Lumefantrine group. Conclusion & Significance: Aqueous extracts of Ochna schweinfurthiana leaf possess inhibitory activity against P. falciparum in-vitro and justifies it folkloric use as antimalarial. 

 

 

Biography:

Abhilasha Karkey is currently working as a Medical Microbiologist at the Oxford University Clinical Research Unit (OUCRU-NP), Kathmandu. Her academic career over the last decade has incorporated periods of rigorous university training and spanned a variety disciplines, including field research experience in community and hospital settings. After successfully completing an MSc from the Liverpool School of Tropical Medicine, she went on to work for Médecins Sans Frontières for four years in various missions across Africa and Asia in emergency conflict situations. She then went on to gain her Doctoral degree from the University of Oxford and started working for her current institution. She is involved with infectious disease research projects that involve enteric fever and antimicrobial resistance among various Gram negative pathogens. Currently, she is an OAK Scientific Leadership Fellow and her research focuses on looking at nosocomial infections and antibiotic resistance patterns within the population.

Abstract:

Statement of the Problem: In 2011 Patan Hospital in Nepal witnessed massive outbreaks of NDM-1 Klebsiella pneumoniae sepsis among neonates in the neonatal intensive care unit. Since then, massive efforts have been made to understand the epidemiology of microorganisms causing bloodstream infections within the local population. Through a 23 year retrospective data analysis, we are trying to understand what significant changes have occurred in the spectrum of organisms and their susceptibility patterns over the years. Additionally, through a prospective study, we will try to understand the epidemiology of multidrug resistant hospital acquired bloodstream infections and identify the risks for bloodstream infections and mortality within Patan Hospital

Methodology & Theoretical Orientation: A 23 year retrospective analysis of all blood cultures taken at Patan Hospital between April 1992 and December 2014 were analyzed. To measure the overall impact of antimicrobial resistance on the outcome of BSI, a prospective hospital wide study is being conducted. Additionally all neonates admitted to the NICU are being enrolled to investigate the risk factors for development of BSI.

Findings: 23 year data documents showed changes in the epidemiology of bloodstream infections in Patan hospital from 1992 to 2014 which include (i) an increase in absolute number of blood cultures positive for Enterobacteriaceae non Salmonella and Gram positive, (ii) an overall increase in resistance to single antimicrobials between 1992 and 2014, (iii) an increase in multidrug resistance (MDR), including an acceleration in the rate of MDR acquisition for Gram positive, and (iv) the high prevalence of MDR isolates in community-acquired infections.