Susceptibility Profiles of Bacterial Pathogens Causing Community-Acquired Urinary Tract Infections

@#Introduction: Uncontrolled empirical treatment of urinary tract infections (UTIs) has negative aspect on predicting the emergence of antimicrobial resistance and knowledge of those patterns has become extremely important from time to time. Therefore, the aim of the present study was to check the prevalence and resistance patterns of uropathogens in the community acquired UTIs. Methods: A total of 7132 urine samples were combined from male 3131 (43.9%) and female 4001 (56.1%) outpatients suspected of having UTIs, respectively over a three-year period and cultured on routine culture media. The bacteria have been identified using basic biochemical tests, and sensitivity to various antibiotics was determined by the method of disk diffusion. Results: Of 7132 urine samples 797 (11.2%) yielded significant uropathogens. Among the bacterial species, Escherichia coli was the major causative agent of UTIs for both gender (63.7%), followed by Klebsiella spp (20.8%), Enterococcus faecalis (5.3%), Pseudomonas spp (4.1%), Proteus spp (3.1%), Enterobacter spp (1.5%), Candida albicans (0.6%), Staphylococcus saprophyticus (0.5%), Providencia spp (0.1%) and Staphylococcus aureus (0.1%). The antibacterial sensitivity testing for E. coli, to commonly used antibiotics were showed variable resistant as follows: Ampicilln (78%), Amoxicillin (71%), trimethoprim sulfamethoxazole (42%), Amox/clav. (14%) gentamicin (20%), nitrofurantoin (11%), nalidixic acid (22%), ciprofloxacin (20%), Imipenem (16%),Ceftazidim (26%),Cefotaxim (25%),Ceftriaxon (21%),Cefuroxim (33%). Conclusions: The findings showed that antimicrobial resistance patterns of uropathogens in variable, and continuous monitoring of resistance patterns by using of antibiotic susceptibility testing in the laboratory is the most appropriate to treat UTIs rather than the choice of UTIs empirical treatment.

Value of patch testing with indigenous battery of allergens in shoe dermatitis

To explore the potential allergens used in our domestic shoe industry and to determine the efficiency of indigenously prepared battery of allergens in shoe dermatitis. A comprehensive list of 49 chemicals used in local processing and manufacturing of footwear was acquired from local sources. Potential irritants were excluded and a finished battery of 20 allergens relevant to our industrial environment was prepared by using standard techniques. Fifty patients and same number of control subjects were enrolled in the study for patch testing using Finn chambers and polyethylene IQ chambers. Results were read using standard protocol at 1 hour, 48 hours, 4[th] day, and 7[th] day. A pre tested, structured questionnaire was filled for each patient. Data were analyzed using SPSS version 12.0 for statistical analysis. Chi square test was applied for comparative analysis between patients and controls. Out of 50 patients 33 [66%] were found to be allergic to 14 different chemicals present in indigenous test battery as opposed to 4 [8%] in control group [p<.0001, chi square test]. Fifteen [30%] patients were reactive to additives used in processing and manufacturing of rubber. Eight [16%] patients were sensitive to agents used in tanning the leather. Four [8%] patients exhibited sensitivity to both leather and rubber and 6 [12%] patients were allergic to the chemicals present in resins, glues, plastics, dyes and metals. No reaction was observed at the site of application of blank chamber and vehicle. The indigenous battery is reliable, cost effective and flexible to adapt to changes in exposure and to introduction of new allergens in market. It would be prudent to recommend exploring the other industries like perfume, garments, and rubber, etc. on similar lines

Value of transverse section scalp biopsy in alopecia areata - a clinicopathological correlation

To correlate the histopathological features of alopecia areata with clinical stage by means of transverse sectioned scalp biopsy specimens, in terms of extent and duration of disease. Cross-sectional. Department of Dermatology, Combined Military Hospital, Kharian Cantonment, Pakistan, from January 2002 to December 2004. Fifty consecutive patients with alopecia areata were included in the study Four millimeter punch biopsy was taken and representative horizontal sections from lower and upper dermis were examined. Patients were divided according to disease extent i.e. Group I [<25% of scalp surface area], Group II [25 - 75% of scalp surface area] and Group III [>75% of scalp surface area including alopecia totalis and universalis]. Patients were also analyzed according to the disease duration, i.e. 0-6 months, > 6-12 months, > 1-5 years and > 5 years. Follicular unit counts and density/ mm[2], terminal to vellus hair ratio, anagen to telogen ratio, cellular infiltrate and fibrosis were measured to assess the diagnosis and prognosis of disease. Chi-square test was used to assess statistical significance. Diagnosis of alopecia areata could be made in 82% of biopsies. Follicular unit counts and density per mm[2] decreased with the disease duration [p=0.01]. Catagen and telogen hair follicle counts increased with disease duration [p=0.0001]. Cellular infiltrate decreased and fibrosis increased with the duration of disease [p=0.0001]. Anagen telogen ratio and terminal to vellus hair ratio inverted in long-standing disease. Transverse section scalp biopsy can help in the diagnosis of alopecia areata and the disease stage can be predicted by analyzing the histopathological findings quantitatively

Effect of high intensity ultrasound on the allergenicity of shrimp / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The tropomyosin fraction of shrimp proteins is potentially responsible for allergic reaction in individuals with genetic predisposition to allergy. However, there are no efficient and safe methods to reduce its allergenicity. High intensity ultrasound is known to change the structure of proteins. This study is aimed at assessing high intensity ultrasound's effect on the allergenicity of shrimp allergen. Shrimp and purified shrimp allergen were treated with high intensity ultrasound for 30-180 min. Extracts of treated samples were analyzed by enzyme-linked immunosorbent assay (ELISA) with pool serum of shrimp allergy patients and polyclonal anti-allergen antibodies and by immunoblotting after polyacrylamide gel electrophoresis. Shrimp treated with high intensity ultrasound showed a decrease in allergenicity measured with ELISA. A linear relationship between the immune response induced by treated shrimp allergen and the applied treatment time was observed. The decrease in allergenicity was confirmed by immunoblot assays with shrimp allergic patients serum. Allergenicity of shrimp allergen extracted from treated shrimp was higher than that of purified shrimp allergen with the same treatment time. Gel-filtration HPLC was applied for analysis of shrimp allergen after treatment with high intensity ultrasound. Some fractions were appeared with increasing treatment time. The results suggested that high intensity ultrasound could be used to reduce the allergenicity of shrimp.

Small vessel vasculitis-a clinicopathological correlation

Small vessel vasculitis in a dermatologic patient may present with clinically indeterminate lesions such as palpable purpura, plaques, nodules or ulcers. In this study, it was aimed to determine the cause of such lesions by correlating clinical with histopathological features to formulate a final diagnosis. This was a study of the descriptive type. Patients of both genders aged between 30-60 years presenting with palpable purpura, plaques, nodules and ulcers of less than 6 months' duration which did not fit into any other disease entity were selected for skin biopsy. The findings on histopathology were correlated with the clinical features for the final diagnosis. A total of 18 patients were evaluated histologically. Six [33.3%] patients were diagnosed as various types of small vessel vasculitis. Five [27.7%] patients were found to be insect bite reactions. Three [16.7%] patients were diagnosed as urticarial vasculitis. There were 2[11.1%] cases of pyoderma gangrenosum and 1[5.55%] each of erythema elevatum diutinum and lupus profundus. In clinically indeterminate cutaneous vasculitic lesions which do not resolve spontaneously, correlation of clinical with histopathological features aids in reaching the diagnosis and prognosis for better patient outcome