Corynebacterium striatum is a known component of normal skin microbiome and is nearly always discarded as contaminants in clinical microbiology laboratories. However it can be a potential pathogen in immuno-compromised as well as immuno-competent individuals, especially those with indwelling medical devices. It has been mostly implicated in causing meningitis, blood stream infections and respiratory infections. We describe a case of meningitis due to C. striatum in an HIV infected individual with external ventricular drainage. Isolation of C. striatum should not be ignored as it can be a potential nosocomial pathogen with a propensity to carry multi-drug resistant genes.

Background: Metallobetalactamase (MBL) producing multi-drug resistant (MDR) Acinetobacter bauminnii in a rural tertiary care centre: prevalence, phenotypic identification and molecular detection of blaVIM and blaIMP gene. Aims: This study was conducted to find the prevalence of MBL and their resistance genes, namely blaVIM and blaIMP in Acinetobacter baumannii strains isolated from specimens received in a rural tertiary care hospital. Methods: Acinetobacter baumannii obtained from various clinical samples were identified by the standard microbiological procedures. MDR Acinetobacter baumannii was identified by the Kirby Bauer disc diffusion method. Double disc synergy test (DDST) and disc potentiation test (DPT) were performed. Minimum inhibitory concentration of Meropenem was determined by the E-test. The presence of the most frequent MBL coding genes blaVIM and blaIMP were detected by multiplex PCR. Results: Highest rate of isolation of Acinetobacter bauminnii 36 out of 100 were from general ICU patients. Resistance pattern revealed 87 isolates resistant to Ceftazidime followed by Ciprofloxacin and Amikacin. Resistance to Meropenem was exhibited by 58 isolates. No resistance to polymyxin-B was observed in the present study. Out of 58 Meropenem resistant, 40 (69%) isolates were found to be MBL producers by Disc potentiation test using EDTA 2.5μl (930 μg per disk). Comparison of DPT and DDST revealed that DPT was more discriminatory. Epsilometer test revealed that 47 isolates hadtheir MIC either in intermediate range or the resistance range. Molecular methods for detection of MBL genes detected 22 isolates to be carrying MBL genes, One isolate of Acinetobacter baumannii was co-producer of blaIMP and blaVIM. Conclusion: In this study, Carbapenem resistance in Acinetobacter baumannii is chiefly mediated by MBL production and the common MBL gene is blaIMP.