ABSTRACT
Objective/background: Fluoroquinolones [FQs] are important anti-tuberculous drugs for the treatment of multidrug-resistant [MDR] tuberculosis. Resistance to FQs leads to fewer options for treatment of tuberculosis [TB], and infection with such strains may also require longer treatment duration. Trends of resistance in Mycobacterium tuberculosis [MTB] are indicators of MTB-resistance evolution. Drivers of such resistance need to be understood and studied to inform preventive strategies
Methods: Here, we present FQ-resistance rates and trends in Pakistan from 2010 to 2015 and compare rates with FQ-consumption data and rates in other community pathogens
Results: Our results reveal a recent decrease in FQ-resistance rates in MTB, but an increase in resistance for Haemophilus influenzae and Shigella spp. Correlation of FQ resistance with FQ consumption at the population level was weak for MTB, although strong associations were noted for H. influenzae and Shigella spp
Conclusion: We discuss the possible reasons for the decrease in resistance rates in TB, putative drivers of resistance other than volume of FQ consumption, and the possible impact of the National Tuberculosis Programme and drug regulatory activities
ABSTRACT
Although the predominant Vibrio cholerae serotype in Pakistan is Ogawa and serotype Inaba is rare, there has been a significant increase in the isolation of Inaba in our referral laboratory in Karachi. This paper reports this observation and further analysis of previous cholera data from 1993 to 2005 to assess the trend of occurrence and resistance pattern of V. cholerae strains. From January to September 2005, 245/3292 [7.4%] specimens yielded growth of V. cholerae. Of these, 243 were serotype Inaba, outnumbering serotype Ogawa. This recent Inaba strain is 100% resistant to cotrimoxazole, 3% resistant to chloramphenicol and not resistant to ampicillin, tetracycline and ofloxacin. This sensitivity pattern is almost similar to that of the previous predominant serotype Ogawa
Subject(s)
Humans , Drug Resistance, Bacterial , Vibrio cholerae O1/immunology , Serotyping , Trimethoprim Resistance , Ampicillin , Feces/analysis , Chloramphenicol , Ofloxacin , TetracyclineABSTRACT
To compare double disc approximation and combined disc method for their ability to detect extended spectrum b lactamase [ESBL] production in enterobacteriaceae and determine the percentage of isolates which are falsely reported as sensitive in absence of ESBL detection, in a clinical microbiology laboratory of a tertiary care hospital between September - October 2002. Selected isolates were identified according to standard biochemical tests. Disc susceptibility tests were performed according to NCCLS. ESBL detection by combined disc [cefotaxime [30ug] versus cefotaxime plus clavulanate [30+10 ug]] was compared with detection using double discs [amoxy-clavulanic acid [20+10 ug] and aztreonam [30ug] applied 10 mm apart]. Results were interpreted according to NCCLS and analysed on SPSS version 10. ESBL production was detected in 140 [30%] isolates by combined disc method and 139 [29.5%] by double disc method. There was no significant difference between two methods. Of the ESBL positive isolates 41[29%] gave zone diameters that were within the sensitivity range cutoff and would have been falsely reported as being beta lactam sensitive in absence of ESBL detection. ESBL detection should be routinely performed in clinical laboratories as false reporting would result in treatment failure despite in vitro sensitivity. No difference was found between the combined disc and double disc methods hence either of two could be used