ABSTRACT
Objective: To assess the prevalence of common pathogens isolated in blood cultures in hospitalized patients at a tertiary care hospital of Lahore
Methods: The retrospective study was done on patients with a higher probability of bacteremia and/or fungemia. Majority of the patients belong to the neonatal and pediatric group, other cases were from ICU, CCU, medical and surgical units. The blood was drawn aseptically from the patient's vein, added to TSB broth, incubated and then cultured. The organisms isolated were identified by biochemical profiling
Results: This study included 1568 patients of blood stream infection [BSI]. Out of these, 225 [14.34%] patients yielded positive blood cultures and 1343 [85.65%] patients did not yield any growth. Among the positive blood cultures 89 [39.55%] were from neonates, 81 [36%] from pediatrics and 55 [24.4%] were from adults. The most common bacterial pathogen isolated in Gram positive organisms was CoNS i.e. 55 [24%] followed by Gram negative Pseudomonas 50 [22.2%], whereas in fungal infections the most common pathogen was Candida spp. 29 [12.88%]
Conclusions: The results of our studies shows the frequency of positive blood cultures in neonates and adults. We can conclude that the frequency is much higher in neonates than adults
ABSTRACT
Objective: 1. To identify the fluorescent signal pattens on WBC histograms in flowcytometry based, five parts differential haematology analyzers, in smear positive cases. 2. To make a diagnostic algorithm based on haematological parameters and WBC scattergrams in suspicious cases of P vivax malaria
Methods: seventy smear positive Plasmodium vivax haematological indices on automated 5 part differential hematology analyzers [XE2100 and XE5000] were checked for seminal use as potential diagnostic markers
Results: seventy smear positive Plasmodium vivax malaria cases were selected. Haematological indices revealed that 83.4% had thrombocytopenia. Pseudoeosinophilia was seen in 76.4% cases with 51/68 showing more than 5% gap. Considerable anaemia [Hb <10 g/dl] was exhibited by 32.8% of the patients. Leukopenia was seen only in 11 cases. Monocytosis was seen in 30 patients
Conclusion: CBC run on automated analyzers gives information in the form of an integrated pattern of results. When thrombocytopenia along with raised MPV and POW, anemia, leukopenia, monocytosis, eosinophilia [Pseudoeosinophilia in actual], abnormalities of WBC scatter-grams, monocytosis and altered ROW are read in collaboration lead to strong suspicion of P vivax malaria infestation
ABSTRACT
Objective: to evaluate the variations in HCV glycoprotein E1 gene and to map epitopes in the variable E 1 regions informing the development of an effective vaccine against HCV
Methods: to isolate the E1 gene, RNA extraction was done by using the kit method and then it was converted to the cDNA. Confirmation of HCV presence in the collected samples was done through highly conserved core primers. This was then followed by PCR amplification for E1 gene. The sequenced E 1 genes were translated in silica into protein sequences
Results: a these proteins sequences were then analyzed for the presence of B-cell and T-cell epitopes; two B-cell epitopes [CSLYPGHLSGHRMAWD, TASIRSHVDLLVGMT] and one T-cell epitope [QAFTFRPRR] were found useful. These could be helpful in the formation of a proper vaccine against HCV
Conclusion: we found 2 B-cell epitopes and 1 T-cell epitope conserved in 3a genotype that may help in vaccine development
ABSTRACT
Objective: to isolate/identify device associated bacteria with their antibiotic sensitivity/resistance patterns in 2015 and to compare them with such 2010 results. Further the impact of MSDS on device associated infections
Methods: this cross-sectional study was carried out by the Microbiology Laboratory on devices or device-associated samples from intensive care units of Services Hospital Lahore in 2015. Bacteria were identified and their antibiotic sensitivities/resistance was tested
Results: samples submitted by ICUs were 446 with 302 from devices. Tracheal samples were 189[62.6%] whereas CV tips [30%] and Folleys catheter [4.3%]. Growth positive samples were 219 [72%]. Non fermentors comprised 54 % isolates with Acinetobacter predominating [33%] followed by Pseudomonas [21.8%]. Enterobacteriaceae were 44% with E coli [16%] Klebsiella [12%] Proteus [10.7%] and Citrobacter [5.9%]. Gram positive isolates comprised [n=23] isolates. Oxacillin resistant were [n=4]. Acinetobacters [n=20] Pseudomonas [n=15] and Enterobactericeae [n=18] with Klebsiella [n=12] were resistantto all drugs tested. ESBLs were 14
Conclusion: DAls are a serious threat in ICU. Surveillance Programmers should be carried out under guidance of INICC
ABSTRACT
To asses the antibiotic resistance pattern of Intensive Care Unit bacterial isolates over two year period; 2009 and 2010. This observational study was carried out on Intensive Care Unit isolates of Services Hospital Lahore in the Microbiology section of Department of Pathology, Services Institute of Medical Sciences Lahore. All samples processed for microbial cultures were tested for anti-biotic sensitivity / resistance pattern studied and compared. In 2009,790 samples and in 2010 886 samples were submitted from ICUs to Microbiology Section for culture. Of these, 42% and 46% were culture positive respectively. Gram negative isolates were 294 in 2009 and 308 in 2010. Resistance to all drugs tested was exhibited by 26 [8.78%] and 39 [12.60%] isolates in 2009, 2010. The total number of Acinetobacter isolated increased to 102 in the year 2010 from 74 in the year 2009 with 28 more Acinetobacters than in 2009 and the number exhibiting extensive drug resistance doubling to 28 from 14. Resistance to Imipenem, Tazobactem and Amikin drugs increased in Acinetobacters, Klebsiella and resistance of E coli to Imipenem also increased but decreased in Pseudomonas and E coli. ORSA and coagulase negative staphylococci with Oxacillin resistance were also on the rise, doubling in number from 12 to 25 and 14 to 31 in 2009 and 2010. Acinetobacter species are on the rise in the intensive care units as is their extensive and multi drug resistance pattern. Increasing Carbepenem resistance is alarming limiting our therapeutic options. Judicious use of antibiotics and curtailing nosocomial infections would deter this upward trend
ABSTRACT
The conclusive diagnosis of tuberculous osteomyelitis requires isolation of Mycobacterium tuberculosis in aspirate from bone lesion and bone debridement. The present study was undertaken to find mycobacterial aetiology in osteomyelitis cases reported to four hospitals in Lahore. One hundred and fifty patients were selected from outpatient departments and Orthopaedic wards of Lahore General Hospital, Sir Ganga Ram Hospital, Services Hospital and Mayo Hospital, Lahore. Specimens of pus from bones and bone debridement were collected. All samples were decontaminated and inoculated on two Lowenstein Jensen slopes. Smears were made and stained by the Ziehl Neelsen method for acid fast bacilli. The Lowenstein Jensen slopes were examined biweekly for eight weeks and any growth obtained was stained by the Ziehl Neelsen method. Cultures for pyogenic bacteria were also put up both for aerobes and anaerobes. Thirteen cases were positive for Mycobacterium tuberculosis: five cases had mycobacterium isolated as a single pathogen, whereas in seven cases there was concurrent infection with Staphylococcus aureus, enterobacteriaceae or both. One case presented with a mixed infection with mycobacterium, Staphylococcus and an anaerobe. These patients were clinically suggestive of tuberculosis on the basis of history, symptoms and signs general and/or pulmonary, typical involvement of spine, chronicity or refractoriness to surgical and antibiotic therapy. The present study highlights the importance of tuberculosis in chronic cases of osteomyelitis. All cases should be cultured for Mycobacterium tuberculosis as it can occur alone or with concomitant pyogenic infection masking its presence leading to failure of therapy
ABSTRACT
The conclusive diagnosis of osteomyelitis requires isolation of pathogen in aspirate from bone lesion, bone debridement and blood culture. The present research was undertaken to study the microbiological pattern of cases of osteomyelitis reporting to four hospitals in Lahore. Method: One hundred and fifty patients of osteomyelitis were selected from outpatient departments and Orthopaedic wards of Lahore General Hospital, Sir Ganga Ram Hospital, Services Hospital and Mayo Hospital, Lahore. Specimens of pus from bone, blood and bone debridement were collected. All samples were inoculated onto two Blood Agar and one MacConkey agar plates. One Blood Agar plate was incubated anaerobically for 48 hours and the other two plates aerobically for 24 hours. Smears were made from samples and stained by the Gram's stain. The colonies obtained were processed according to the technique of Mackie and MacCartney. The commonest isolates belonged to the Enterobacteriaceae [32.8%], followed by Staphylococcus aureus [29.5%], Pseudomonas aeruginosa [15.5%], anaerobes [2.6%] and miscellaneous [19.3%]. Five [2.7%] anerobic bacteria were isolated. Anaerobic bacteria were peptostreptococci, peptococci and bacteroides either alone or as a mixed infection. The present study highlights the importance of microbiological examination of bone in cases of osteomyelitis. Different types of bacteria either alone or as a mixed infection could be the causative agent[s]