In vitro efficacy of Colistin against multi-drug resistant Pseudomonas aeruginosa by minimum inhibitory concentration

Multi-drug resistant bacteria are an important cause of mortality and morbidity. In the management of various infections, timely detection and appropriate treatment, in accordance with the culture and sensitivity reports can help improve the treatment outcome. Colistin is a bactericidal antibiotic which is emerging as a reliable solution for treating infections with multi-drug resistant Gram negative bacilli. The aim of this study was to find out the in-vitro efficacy of colistin against multidrug resistant Pseudomonas aeruginosa isolates by minimum inhibitory concentration. This cross sectional, descriptive study was conducted in the Department of Microbiology, Army Medical College, National University of Sciences and Technology, Islamabad from February 2010 to January 2011. Antimicrobial sensitivity testing was done on Pseudomonas aeruginosa isolated from routine clinical specimens received and the strains which appeared resistant to at least one antimicrobial agent in three or more anti-pseudomonal antimicrobial categories were subjected to the Colistin Etest. The MIC endpoint of colistin was read, as per manufacturer's instructions [AB Biodisk, Solna, Sweden]. The isolates showing MIC of 2micro.g/ml or less were considered sensitive, those with 4-6 micro.g/ml as intermediate and >/= 8 micro.gg/ml as resistant. MIC[50] and MIC[90] of colistin against MDR Pseudomonas aeruginosa was determined. A total of 52 MDR Pseudomonas aeruginosa strains were isolated during the period of the study. The highest percentage was isolated from urine [36%] followed by respiratory tract infections [18%] and pus specimens [20%]. The highest percentage of these isolates was found to be susceptible to colistin followed by piperacillin-tazobactam and cefoperazone-sulbactam. A total of 36 [69%] isolates were sensitive, 10 [20%] were intermediate and 6 [11%] were resistant to colistin by Kirby Bauer disc diffusion method. MIC[50] was found to be l.0 micro.gg/ml while MIC[90] was 3.0 micro.gg/ml. Colistin is a reliable solution in cases of infections with MDR, XDR or PDR Pseudomonas aeruginosa

Prevalence of HBV and HCV in young healthy adult males seeking recruitment in Pakistan rangers [Punjab]

To find the prevalence of HBV and HCV infection among healthy adult males seeking recruitment in Pakistan Rangers [Punjab]. Healthy adult males 18- 25 years old across Pakistan with no previous history of jaundice or any clinical symptoms recruited in Pakistan Rangers [Punjab]. After having cleared the physical efficiency tests, blood samples were collected in gel clot containers and appropriately labeled. HBsAg and anti-HCV antibodies were tested by rapid immuno chromatographic method [Excel]. All the positive samples were confirmed by Abbott Murex enzyme immuno assay version III [HBsAg] and Murex enzyme immuno assay version IV [anti HCV]. During the study period 2960 individuals belonging to the province of Punjab were screened for hepatitis B and C virus infections. The study carried out on the recruits from Punjab showed 101 [3.4%] positive for HBsAg and 201 [6.79%] for anti HCV on screening. Ten individuals found positive for HCV on screening left the training and did not give samples for confirmation by the ELISA method. On confirmation by Murex enzyme immuno assay version III and IV [for HBsAg and anti-HCV] of the remaining 96 [3.24%] were positive for HBsAg and 160 [5.4%] for anti HCV. The specificity of immuno chromatographic methods for HBsAg and anti HCV was calculated by the Murex Version III and IV EIAs respectively the gold standard was to found be 99.8% and 98.9% respectively. District wise prevalence of HBsAg varied from 0.64% [Chakwal] to 5.6% [Sargodha] and that of anti-HCV from 1.1% [Jhelum] to 12.6% [Sahiwal]. The prevalence of anti HCV was also found to be high in Sahiwal [12.6%], Okara [11.33%], Faisalabad [10.85] and Jhang [8.9%]. This study reveals the overall prevalence of HBsAg to be 3.24% and that of anti HCV 5.4%