ABSTRACT
Objective: The objectives were to assess the frequency of hospital acquired pneumonia [HAP] in patients admitted to intensive care unit [ICU] and to determine the frequencies of different etiological organisms in these patients
Methods: This was descriptive cross sectional study, which was carried out in medical ICU of Shifa International Hospital Islamabad from January 2013 to January 2014, A total of 1866 patients were admitted in the department of medicine including medical ICU. They were evaluated for HAP and the causative organisms were cultured from these patients. Identification was carried out by standard biochemical profile of the organisms
Results: The total number of patients admitted in medical ICU for any reason were 346. HAP was diagnosed in 88 patients [25.4%]
The average age of patients admitted in Medical ICU with HAP was 48 years with the range of 16 to 82 years. 56 were male and 32 females. 42 patients [47.7%] died in medical ICU with HAP. Microbiological analysis showed that Pseudomonas oeruginosa were 27 [30.6%], Adnetobacter spp. Were 12 [13.6%], Candida albicans were 12 [13.6%], Klebsiellapneumoniae were 9 [10.2%], Streptococcus spp. were 9 [10.2%], Escherichia coli were 5 [5.6%], Stenotrophomonas spp. were 4[4.5%], Methicillin Resistant Staphylococcus Aureus [MRSA] were 4 [4.5%] others organisms 6 [6.8%]
Conclusion: The frequency of HAP in Medical ICU of our hospital is 88 out of 346 [25.4%]. The commonest organism identified was Pseudomonas aeruginosa [30.6%] followed by Adnetobacter and Candida albican [13.6% each]
ABSTRACT
Hyperbilirubinemia due to glucose 6 phosphate dehydrogenase [G6PD] deficiency can cause permanent neurological damage and death in neonates. Screening for the enzyme enables timely diagnosis and treatment in cases of G6PD related kernicterus. Knowledge of patient G6PD status is also important in treatment of malaria, a disease endemic in Pakistan. World Health Organization recommends mandatoryuse of primaquine for radical cure and eradication of malaria. Since, Primaquine, causes hemolysis in G6PD deficient cases, widespread adoption of the drug is viewed with caution. This study assessed frequency of G6PD deficiency in Pakistani noenates and examines the need for its screening based on local disease prevalence and malaria endemicity. A cross sectional study was carried at Hematology Department, Army Medical College [MUST], in collaboration with Military Hospital, Rawalpindi, Pakistan.[January - August, 2011]. The frequency of G6PD deficiency in newborn population was determined by quantitative [spectrophotometric] method. Cord blood [2.5 ml blood in K3EDTA bottle] samples were obtained from 240 newborns [male: female 1.2:1] after informed consent from parents. Data obtained was analyzed using SPSS Windows version 17. Frequency of G6PD deficient cases was 4.2%. Among the ten G6PD deficient patients, six had severe enzyme deficiency [<10% enzyme activity]. The local prevalence of G6PD deficiency and its potential complications qualify it as a disease that must be screened for. Also, prior knowledge of patient G6PD status enables the physician to revert to modified treatment regimen for malaria only in enzyme deficient cases and not otherwise
Subject(s)
Humans , Male , Female , Infant, Newborn , Glucosephosphate Dehydrogenase Deficiency/diagnosis , Cross-Sectional Studies , Mass Screening , Malaria , PrevalenceABSTRACT
To determine the in vitro efficacy of Piperacillin/Sulbactam, Piperacillin/Tazobactam and Cefoperazone/Sulbactam against clinical isolates of Pseudomonas aeruginosa. Cross-sectional study Department of Microbiology, Armed Forces Institute of Pathology from January 2010 to September 2010. A total of 287 isolates of Pseudomonas aeruginosa recovered from various clinical specimens were taken under consideration. Routine microbiological methods were used to identify the organism. Susceptibility of the isolates was carried out by modified Kirby-Bauer disc diffusion method against piperacillin 100/sulbactam 30 [SPR130micro g], cefoperazone 75/sulbactam 30 [SCF105micro g] and piperacillin 100/tazobactam 10 [TZP110micro g], according to the guidelines provided by Clinical and Laboratory Standards Institute [CLSI]. The highest numbers of Pseudomonas aeruginosa isolates were found in pus swabs, followed by urine and endobronchial washings. Seventy five percent of clinical isolates of P. aeruginosa were susceptible to tazobactam/piperacillin, 71% to piperacillin/sulbactam and 70% to cefoperazone/sulbactam. The difference between the susceptibility of isolates to these three antimicrobials was statistically not significant [p>0.05]. We conclude that there was very little difference in the antimicrobial susceptibility of P. aeruginosa to the three beta-lactam/beta-lactamase inhibitor combination drugs studied. Periodic susceptibility testing should be carried out over a period of two to three years, to detect the current resistance trends. Moreover, a rational strategy on the limited and prudent use of anti-Pseudomonal agents is urgently required
ABSTRACT
To determine the role and pattern of non-dermatophyte moulds as causative agents of onychomycosis. Case series. Department of Microbiology, Armed Forces Institute of Pathology [AFIP], Rawalpindi, from November 2009 to July 2010. Nail clippings and nail scrapings were obtained from abnormal looking nails with treatment and detection failure for onychomycosis. Microscopic [40% potassium hydroxide mounts] examination and culture on Sabouraud's dextrose agar [SDA], SDA containing chloramphenicol, and SDA containing actidione and chloramphenicol were used for species identification. Non-dermatophyte moulds were isolated from 32 out of the total 47 culture positive cases [68%]. Alternaria alternata was the commonest species [46%]. Dermatophytes were isolated from only 7 patients [15%] belonging to genus Trichophyton. Yeasts were isolated in 8 [17%]. There was no fungal growth in 53% of cases. The non-dermatophytes should be considered important in evaluating the culture negative cases for dermatophytes as well as those cases ending up in treatment failure after empirical treatment for dermatophyte infections