Clinical and lab-assessed antibiotic resistance pattern of uropathogens among women with acute uncomplicated cystitis

Background: acute uncomplicated cystitis [AUC] in females is among the most frequent infections in community. Treatment of AUC in Egypt usually based on empirical therapy

Objectives: To determine the most common uropathogens and their pattern of resistance to commonly used antimicrobials aiming at finding a proper antibiotic which can be used as effective empirical therapy in AUC

Patients and Methods: Observational, hospital based, cross sectional study was performed. Three hundred and twelve female patients were recruited for the study with positive urine culture and clinical symptoms correlate with AUC during the period from December 2017 to August 2018

Results: Eight organisms were isolated. E. coli was the most common uropathogen and was isolated from 231 cases [74%]. The next most common was Pseudomonas which was detected in 41 cases [13.1%]. Other organisms include MRSA [6.1%], Klebsiella [2.2%], Enterococcus spp. [1.9%], proteus [1.3%], Acinetobacter and Staph. aureus [0.6%] each. Isolated uropathogens in this study were least resistant to Nitrofurantoin [47.1%]. The highest resistance rate was to TMP/SMZ [87.8%]. Resistance pattern to quinolones were 64.1%, 67% and 60.6% to Ciprofloxacin, Norfloxacinand and Levofloxacin respectively

Conclusion: The most common cause of community acquired AUC was E. coli. Nitrofurantoin can be used as a first line empirical therapy for AUC as it showed the least resistance pattern [47.1%]. Antimicrobial resistance is a crucial issue which evolves continuously and thus more studies must be carried out in different regions and constanttime intervals

correlation between magnetic resonance imaging and the operative and clinical findings after lumbar discectomy

Forty two patient were admitted to Mansoura University Hospital for treatment of lumbar disc prolapse. They were studied prospectively with magnetic resonance imaging before they had open discectomy, and the findings were correlated with clinical symptoms before and after operation and with the operative findings. There were 26 males and 16 females. The patients aged between 25 and 60 years with an average of 37.5 years. MRI studies showed, a sequestrated fragment in 59% of patients, a subligamentous disc sequestration in 25% and a disc protrusion in 16%. In twenty five patients the operated level was [L4-L5], while in 16 patients the operated level was [L5-S1], and only in one patient, the operated level was L3-L4. The diameter of the protrusion was 4 mm to 13 mm for the craniocaudal extension, and 5 mm to 18 mm for the anteroposterior extension. No correlation could be found between the neurological deficit and the size of the disc prolapse. There was significant correlation between obstruction of the spinal canal and the type of the disc lesion, either extrusion, subligamentous disc sequestration, and free sequestration. Magnetic resonance imaging is a helpful pre-operative diagnostic investigation which shows structural changes in the disc and the correct localisation and size of the disc sequestration, but there was no correlation between the imaging findings and the clinical symptoms

Gastric pull-up after total pharyngolaryngectomy

In this study, 50 patients with hypopharyngeal carcinoma underwent gastric pull-up following total laryngopharyngectomy. The postoperative mortality was 10% and the postoperative morbidity was mainly due to pleural injury, hemorrhage, minor fistulae and mediastinitis. It was found that fistulae occurred in 16% of the cases, hemorrhage in 4% and abdominal wound dehiscence in 4%. The perioperative mortality was 10% in the cases