Pattern of Antimicrobial Susceptibility of Klebsiella Pneumoniae Isolated from Urinary Samples in urinary Tract Infection in a Tertiary Care Hospital, Kishanganj, Bihar, 5 Years’ Experience

Background: Urinary tract infection is very commoninfection in the community and hospital and multi drugresistant klebsiella pneumoniae is noted as most alarmingprevalent infecting organism worldwide. The aim was toknow the pattern of susceptibility to antibiotics of klebsiellapneumoniae in urinary tract infection.Materials and methods: In this retrospective cross sectionalstudy morning midstream urine sample of 1550 symptomaticpatients was taken for culture and sensitivity. Only 208patients’ (145 females and 63 males) urine demonstratedgrowth of klebsiella pneumoniae susceptible to differentantibiotics.Results: Out of 208 patients 145 were females (69.71%) and63 males (30.28%). Klebsiella pneumoniae was sensitiveto was highly sensitive to polymyxin (91.82%), colistin(89.42%), Imipenem (88.94%), meropenem (79.32%),ertapenem (75%), moderately sensitive to aminoglycosidegroup (amikacin 59.13%, gentamicin 52.40%, Netilmicin50.96%), piperacillin-tazobactam (53.84%) mildly sensitive totobramycin (49.51%), nitrofurantoin (48.07%), cefoperazonetazobactam (45.67%) levofloxacin (45.19%). Least sensitivedrugs (below 20%) were chloramphenicol, ticarcillin,amoxicillin, amoxicillin-clavulanic acid, cefuroxime,azithromycin, aztreonam, cefoxitin.Conclusion: Since multi-drug resistant klebsiella pneumoniaebecome highly prevalent in the community, so prevention inthe form of health education to the community as well asearly detection of resistance to different antibiotics is veryappropriate to prevent the spread of resistance

A patient presenting with recurrent post-prandial abdominal discomfort and vomiting.

Duodenal diverticulum is the second most common diverticulum of gastrointestinal tract. Among duodenal diverticulum, incidence of intramural duodenal diverticulum is 100 as per report till date. It is usually asymptomatic, but in middle or adult age, it may present with postprandial abdominal discomfort, often complicates in the form of bleeding, perforation or rarely neoplasm. So, this congenital duodenal deformity requires urgent definitive treatment. Here we presented a case presenting with postprandial abdominal discomfort with occasional vomiting. He was advised upper gastrointestinal endoscopy. It showed evidence of duodenal septa at the junction of 1st and 2nd part. Scope was negotiated through one channel. He was advised barium meal of stomach, duodenum and follow through, which ultimate demonstrated presence of a rare abnormality, duodenal intramural diverticulum, which if not treated, can produce severe complication in future.