Antimicrobial sensitivity pattern of urine isolates from asymptomatic bacteriuria during pregnancy

Screening women for asymptomatic bacteriuria [ASB] on the first antenatal visit is a part of standard obstetric care. Treating women with ASB decreases the chances of maternal and f0etal complications. This study was conducted to find out the spectrum of urine pathogens and their drug susceptibility pattern for ASB during pregnancy. The study was conducted in the Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre Karachi, from September 2001 to March 2002. Two hundred and ninety women, apparently normal with confirmed pregnancy, were registered. A voided midstream urine specimen was collected and cultured. A significant growth i.e. >/= 105 organisms/ml was identified with Analytical Profile Index 20 tests for identification of Enterobacteraceae [API-2o-E] and for Gram positive cocci by other standard methods. The prevalence of ASB was found 6.2%. Antimicrobial sensitivity was determined by disc diffusion Kirby Bauyer method after matching the turbidity with 0.5 McFarland's standard. Most of the recommended drugs were found to have encouraging results, however, Escherichia coli showed 66.67% resistance to ampicillins and sulphonamides. Enterobacters showed 100% resistance to ampicillins, cephalosporins and nitrofurantoin. Staphylococcus saprophyticus showed 66.67% resistance to ampicillins and sulphonamides. It was concluded that detection of ASB during pregnancy and appropriate use of antimicrobials is only possible after culture of urine. Empirical anti-microbial therapy cannot be relied upon because of possible risk of resistance

Prevalence of asymptomatic bacteriuria in pregnant women

To study the prevalence of asymptomatic bacteriuria [ASB] in pregnant women of local population in Karachi. Prospective, hospital based conducted during September 2001-March 2002. Basic Medical Sciences Institute, Jinnah Postgraduate Medical Center Karachi. Group A [study group] consisted of 290 pregnant women attending the OPD of Gynaecology and Obstetrics units for antenatal check up and Group B [control] consisted of 70 nonpregnant women of fertile age. Midstream urine was collected and aerobically incubated at 37°C on CLED agar. Growth of >1x10[5] CFU/mL was taken as significant bacteriuria. Gram-negative bacteria were identified by API 20-E and gram-positive by standard routine methods. The two groups were age matched [P value>0.05]. Prevalence of asymptomatic bacteriuria was 6.2% [18/290] in the study group and 2.85%[2/70] in control group. E. coli was the common uropathogen in both groups and Staph. saprophyticus the second common only in-group A. Prevalence of ASB remained statistically the same in pregnant and nonpregnant women [P value >0.05] by X[2] application. Prevalence of ASB before pregnancy continues during pregnancy, if not treated. Uropathogens remain the same. All pregnant women should be screened for ASB by culture

study of neonatal aerobic bacterial septicemia

Septicaemia is an important cause of morbidity and mortality in neonates. A study was done at the Pakistan institute of Medical Sciences [PIMS], Islamabad to identify the commonly responsible aerobic bacteria causing septicaemia and finding their sensitivity to antimicrobials which could help in reducing mortality and morbidity in neonates. During one year [November 1991 to October 1992], 81 clinically suspected cases of neonatal septicaemia were investigated by performing blood culture. Forty-five organisms were isolated from 44 blood culture positive cases. Klebsiella was the most frequent and isolated from 28 patients [62%] followed by staphylococcus coagulase-negative [8.9%], staphylococcus aureus [6.7%] and Escherichia cloi [6.7%]. One case each of Pseudomonas aeruginosa, Proteus mirabilis and Salmonella spp. was isolated. Klebsiella pneumoniae were multiple-drug resistant. They were sensitive to amikacin [89%], ceftazidime [70%] and cefotaxime [52%]. Other isolates also demonstrated a similar pattern of sensitivity

Gentamicin resistant aerobic gram-negative rods in a teaching hospital

During 1993, 445 [44.86%] gentamicin-resistant aerobic gram-negative rods were detected by disc diffusion susceptibility testing from 992 gram negative isolates. Predominant organissm were Pseudomonas [175], Klebsiella pneumoniae [168], Escherichia coli [61], Proteus [30], Enterobacter [7], and Samlonella typhi [4]. Two hundred and fifty-four organisms were isolated from pus/wound specimens, 101 from urinary sources, and 51 from sputum. Sensitivity to antimicrobials demonstrated that almost all gentamicin-resistant rods were resistant to ampicillin and cotrimoxazole. Sensitivity of Pseudomonas and Klebsiella, which comprised 77% of isolates, was; amikacin 96% sensitivity for both, ceftazidime 70.3% and 60.1%, cefotaxime 30.3% and 38.7%, ofloxacin 50.3% and 54.8%, ciprofloxacin 70.3% and 64.5%, and nitrofurantoin [for urinary isolates] 26% and 57.1% respectively

carrier state: methicillin-resistant staphylococcus aureus: a hospital study screening of hospital personnel for nasal carriage of staph aureus

Methicillin resistant Staph Aureus [MRSA] were studied in a 300 bedded Central Government Hospital Rawalpindi, in which 291 staff members were screened by nasal swabbing. Of 125 cases carrying staph aureus 5 [1.78%] were methicillin resistant. They were treated with Bacitracin ointment to be applied to interior nares four times a day for one week. Hexachlorophane baths daily, chlorhexidine shampoo once daily for a week, and were taken. off duty from wards for one day